Senior Payment Accuracy Specialist in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Senior Payment Accuracy Specialist in United States.

This role sits at the core of healthcare payment integrity, combining advanced audit expertise, data-driven analysis, and leadership in concept development to improve claims accuracy and recoverable value. You will work on complex audit initiatives that directly impact financial performance for healthcare clients while helping define and refine new audit methodologies. The position blends hands-on technical auditing with strategic collaboration, client interaction, and mentorship of junior team members. You will evaluate claims, contracts, and reimbursement logic to identify opportunities for recovery and process improvement. Acting as both a technical expert and trusted advisor, you will help shape audit concepts that scale across multiple healthcare verticals. This is a high-impact role for someone who thrives in analytical environments and enjoys transforming complex healthcare data into actionable outcomes.

The Senior Payment Accuracy Specialist is responsible for developing, executing, and refining advanced audit concepts that improve healthcare payment accuracy and generate recoverable claims. This role also ensures audit quality, supports client engagement, and contributes to the development of tools, processes, and team capabilities across the audit function.

• Develop and enhance new and existing audit concepts, including defining methodologies, testing with clients, and driving concept adoption.
• Conduct complex audit projects independently, analyzing claims data, identifying discrepancies, and validating recovery opportunities.
• Review provider contracts and reimbursement rules to ensure accurate interpretation of policies, regulations, and payment structures.
• Lead quality control processes by reviewing audit outputs before and after client submission to ensure accuracy and compliance standards.
• Prepare and respond to client disputes by validating claims findings and supporting recovery justifications.
• Validate new claim types and evaluate effectiveness of audit concepts in terms of recovery, accuracy, and client acceptance.
• Support development of audit tools, reporting enhancements, and process improvements in collaboration with cross-functional teams.
• Mentor and train audit staff, contributing to skill development, performance improvement, and knowledge transfer across teams.

This role requires strong healthcare claims auditing experience, advanced analytical skills, and the ability to work with data and coding tools to drive accurate payment validation. The ideal candidate combines technical expertise with leadership ability and strong communication skills.

• Bachelor’s degree preferred or equivalent experience.
• 3+ years of direct audit experience or 4+ years of experience in healthcare billing, claims, reimbursement, or analytics.
• Strong experience working with healthcare claims data, reimbursement methodologies, and industry standards.
• Proficiency in SQL and strong computer skills including Microsoft Excel and Access.
• Ability to analyze complex datasets and translate findings into clear, actionable insights.
• Experience mentoring or training team members to improve audit quality and productivity.
• Strong written and verbal communication skills with the ability to interact across technical and client-facing environments.
• Ability to work independently and collaboratively in a fast-paced, detail-oriented environment.

• Competitive hourly compensation ranging from $37.75 to $40.25 per hour, with eligibility for discretionary bonuses.
• Comprehensive benefits package including medical, dental, vision, disability, and life insurance.
• 401(k) retirement savings plan.
• Paid time off ranging from 17–27 days depending on tenure, plus 9 paid holidays annually.
• Paid family leave and additional family support benefits.
• Fully remote work setup with required secure home office and reliable connectivity.
• Overtime eligibility for nonexempt hours worked beyond 40 per week.
• Opportunity to work on high-impact healthcare payment integrity initiatives with measurable outcomes.