Job Description

Our Ideal Candidate

As a Fee Schedule Specialist, you'll be responsible for researching, developing, and maintaining state-specific fee schedule requirements to ensure compliance across all relevant business units. This role plays a key part in keeping our systems and teams up to date by clearly communicating updates and supporting testing and validation to ensure accurate implementation. In addition to these core responsibilities, you will collaborate with the tech team to help onboard and automate fee schedule data into our systems, supporting greater efficiency and accuracy.

Responsibilities

• Partner closely with Bill Review leadership to stay current on new and existing state regulations.
• Provide clear and accurate fee schedule guidance and compliance support to internal teams, including product, project, and business development teams.
• Interpret complex fee schedule rules and regulatory requirements and translate them into actionable insights for system updates and business operations.
• Develop training materials and resources to educate teams across the organization on fee schedule compliance.
• Stay up to date on billing codes (CPT, HCPC, revenue codes) and reimbursement rules, ensuring our processes align with state-specific regulations.
• Collaborate with tech teams and the Bill Review Manager to ensure that fee schedule rules and validation logic are correctly built into our system.
• Support ongoing projects with expert compliance input and assist in troubleshooting fee schedule-related issues.
• Other duties as needed.

Qualifications

• Bachelor's degree in a related field preferred, but not required.
• 3+ years of experience in workers' compensation, healthcare reimbursement, or a related field.
• Strong background in regulatory documentation and the ability to communicate state regulation updates clearly to diverse teams.
• Experience working with engineering and compliance teams to ensure proper system implementation of regulatory changes.
• Excellent written, verbal, and interpersonal communication skills.
• Strong organizational skills with the ability to manage complex tasks independently.
• High attention to detail and ability to meet deadlines in a fast-paced environment.
• Comfortable working with Microsoft Office tools, especially Excel, Word, and Outlook.
• Proactive, solution-oriented, and able to collaborate across departments with a team-first attitude.

Please Note: At this time, we are unable to consider applicants who require work visa sponsorship. Candidates must be authorized to work in the United States without current or future sponsorship.

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