Salary :
This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Payment Policy Manager - REMOTE. In this vital role, you will develop, implement, and manage payment policies and strategies that optimize revenue while ensuring compliance with federal, state, and payer-specific guidelines. You will analyze regulatory changes and reimbursement models to support the organization's financial performance and collaborate closely with clinical, financial, and revenue cycle teams. This is an opportunity to significantly impact patient care and operational efficiency in a remote work setting.
Accountabilities
- Evaluate and align ClaimsXten/CCI configuration with approved business requirements and payment policies.
- Lead discussions regarding coding, configuration, and claims adjudication using your claims experience.
- Support and enhance ClaimsXten documentation in the Claim Editing Repository.
- Research and create documentation on medical billing and coding rules.
- Stay updated with CMS coding regulations and develop documentation for PPGs.
- Publish recommendations to senior leadership on coding rules and payment policies.
- Draft new and revised written provider payment guidelines.
- Coordinate publishing and distribution of finalized PPGs.
- Participate in cross-functional teams to present findings on medical coding issues.
- Serve as a subject matter expert on payment policies for corporate projects.
Requirements
- Bachelor's Degree required.
- Certified Professional Coder (CPC) highly preferred.
- 5-7 years of experience in payment policy management or healthcare finance.
- 1-2 years of leadership or supervisory experience.
- Experience with claims editing and ClaimsXten system is highly preferred.
- Ability to prioritize work and operate under tight deadlines.
- Strong aptitude for technology-based solutions.
- Experience in policy development and contract management.
Benefits
- Competitive salary range of $62,400.00 - $90,750.40 annually.
- Comprehensive benefits package.
- Career advancement opportunities.
- Quarterly onsite meetings (preferred, not required).
- Flexible remote work environment.
Why Apply Through Jobgether?
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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