At XiFin, a culture of inclusivity is in our very fabric. We believe that this culture not only creates a more equitable and functional workplace, but also enhances our team members' work experiences by promoting creativity, innovation, and collaboration.
Who are we looking for?
The Payor Regulations and Strategy Specialist is responsible for proactively reviewing and researching payor updates, determining appropriate follow-up actions and processes, and communicating findings to internal and external customers. Successful candidate will have excellent interpersonal and communication skills and exceptional analytical, investigative, and organizational skills. You will be comfortable working in an environment of high demands and have the ability to balance and streamline multiple priorities.
What will you do?
- Remain informed of regulatory changes and developments in the regulatory environment
- Analyze denial patterns and trends and develops action plans to address findings
- Collaborate with department leaders to understand changes and develop internal standard operating procedures
- Follows company procedures to notify both internal and external customers of findings
- Relate with all levels of employees to discuss regulations, standards, and company policies with the aim of providing education as needed
- Assist Regulatory Research process by advising of industry changes, providing QA of data loads, and assisting with related customer inquiries
- Protect patients’ rights by maintaining confidentiality of personal and financial information in order to comply with HIPAA and privacy requirements
This is an onsite position at our office in either our Charleston, SC, San Diego, CA or Dallas, TX.
What education and experience do you need?
A combination of the following education and experience factors will be considered:
- Degree in Healthcare Admin, Business, Finance, or related field
- Minimum of 5 years’ experience preferred in a medical claims/billing environment involving payor regulations
- Knowledge of CPT-4 and ICD-10 coding guidelines, governmental and commercial payor regulatory affairs specific to pathology and laboratory billing
- Exceptional analytical, investigative, and organizational skills
- Excellent interpersonal and communication skills
- Proficient with Microsoft Office (Excel, Outlook, Word)
What’s in it for me?
We don't just offer benefits; we offer a comprehensive and flexible benefits package tailored for you!
- Dive into a world of cutting-edge healthcare with our comprehensive medical, dental and vision benefits, including telehealth services. Say goodbye to the hassle of prescriptions with our convenient mail-order program for 90-day maintenance medications.
- Our Health Savings Account (HSA) featuring pre-tax deductions and quarterly company contributions (HSA only) puts more money in your pockets!
- Plan for your golden years with confidence through our 401k retirement plan, complete with a company match.
- Fuel your ambition with our Tuition Assistance program, empowering you to reach new heights in your professional journey.
- Finally, experience true well-being with XiFin's BeWell Program, where we champion physical, mental, financial, and social wellness, because your success and happiness are our ultimate priorities
Why XiFin?
XiFin is a healthcare information technology company that empowers healthcare organizations to navigate an increasingly complex and evolving healthcare landscape. Through innovative AI-enabled technologies and services, we deliver operational efficiency, interoperability, and simplicity. The company’s revenue cycle management, clinical workflow enablement, laboratory information system, and patient engagement solutions enable organizations to achieve stronger finances, streamline operations, and develop industry-leading business strategies.
Helping healthcare providers achieve financial strength empowers them to do more good for more people. That’s THE POWER TO DO GOOD.
What does the position pay:
Compensation is determined by several factors which may include skillset, experience level, and geographic location.
The expected range for this role is $60,000.00-80,000.00 annual compensation. Please note this range is an estimate and actual may vary based on qualifications and experience.
If you are an individual with a disability and would like to request a reasonable accommodation as part of the application or recruiting process, please contact us at 858-436-2901.
EEO Statement
XiFin is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.