Jobs in the United States

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Added 21 mins ago
SC
(USA) Area Manager
Sam's Club
GROVEPORT, OH
- $65,500 to $98,000 USD / year
…andcoordinating workloads in order to achieve facility goalsIdentifies associate customer and supplier concerns by listening and consulting with others when needed to determine corrective…
Added 1 hour ago
UO
Business System Professional
University of Colorado Denver
Boulder, CO
- $65,000 to $70,000 USD / year
…processes to ensure accurate account management, effective problem resolution, and consistent support of program…
Added 1 hour ago
Facilities Manager
BKF
Remote, United States
The Real Estate & Facilities Manager supports the Associate Vice President (AVP) in overseeing real estate and facilities operations across a multi-office consulting firm with 25+…
Added 1 hour ago
Facilities Manager
BKF
Remote, United States
The Real Estate & Facilities Manager supports the Associate Vice President (AVP) in overseeing real estate and facilities operations across a multi-office consulting firm with 25+…
Added 1 hour ago
Facilities Manager
BKF
Remote, United States
The Real Estate & Facilities Manager supports the Associate Vice President (AVP) in overseeing real estate and facilities operations across a multi-office consulting firm with 25+…
Added 1 hour ago
Facilities Manager
BKF
Remote, United States
The Real Estate & Facilities Manager supports the Associate Vice President (AVP) in overseeing real estate and facilities operations across a multi-office consulting firm with 25+…
Added 2 hours ago
UO
Senior Assistant Director of Slate
University of Colorado Denver
Boulder, CO
- $82,000 to $83,000 USD / year
…Senior Assistant Director of Slate! This position reports to the Associate Director of Systems and Technology and maintains the undergraduate instance of the Technolutions Slate system for…
Added 2 hours ago
UO
Open Rank Regular Faculty: Assistant - Full Professor
University of Colorado Denver
Aurora, CO
- $110,000 to $150,000 USD / year
…core facilities that include advanced light microscopy, super resolution nanoscopy, rodent in vivo behavior and electrophysiology, neural engineering, and a machine shop…
Added 2 hours ago
IT Network Administrator
USA DeBusk LLC
Houston, TX
Respond to outages and service interruptions with root-cause analysis and resolution.
Added 3 hours ago
Group Leader- Seats Gold
Toyota Boshoku America Inc
Princeton, IN
Added 3 hours ago
Manufacturing Group Leader
Toyota Boshoku America Inc
Jackson, TN
Added 3 hours ago
Quality Control Group Leader
Toyota Boshoku America Inc
Lawrenceville, IL
Added 3 hours ago
Group Leader- Weld Nights
Toyota Boshoku America Inc
Princeton, IN
Added 3 hours ago
Production Control Group Leader Evening
Toyota Boshoku America Inc
Princeton, IN
Added 3 hours ago
Group Leader
Toyota Boshoku America Inc
Lawrenceville, IL
Added 3 hours ago
Quality Group Leader
Toyota Boshoku America Inc
Jackson, TN
Added 3 hours ago
Director, Client Services (Wealth Management)
Bartlett Wealth Management
Remote, United States
Champions proactive client service, client advocacy, and problem resolution to improve the client experience.
Added 3 hours ago
Business Support Technician
Midcontinent Communications
Sioux Falls, SD
Added 3 hours ago
K
Deputy Project Quality Manager-Kiewit Nuclear Solutions-ID
Kiewit
Aiken, SC
- $134,000 to $140,000 USD / year
…have excellent written / verbal communication and conflict resolution skills, manage a diversified workload and challenging situations efficiently and effectively, have a Continuous…
Added 4 hours ago
MC
Tech II-Lab Processing - PX Central Processing
Mayo Clinic
Phoenix, AZ
- $20.98 to $29.19 USD / hour
Associate's degree in a health or science related field and one (1) year of experience in a clinical laboratory preferred. Demonstrated aptitude for working in a laboratory or interest in…
Added 4 hours ago
Associate Cobol Technical Analyst
Highmark Health
Jefferson City, MO
…delivery. Also supports identification, documentation, and resolution of risks, defects and issues. May analyze market trends for competitive insight to correlate into business value…
Added 4 hours ago
GA
Sr Staff Applications Operations Engineer - Engineering Tools Automation & AI Ops
GE Aerospace
Saint Louis, MO
- $131,000 to $174,000 USD / year
+ Drive consistent incident, problem, and change management across pods; lead resolution of high-severity escalations and root cause analysis.
Added 4 hours ago
GA
Sr Staff Applications Operations Engineer - Engineering Tools Automation & AI Ops
GE Aerospace
Kansas City, MO
- $131,000 to $174,000 USD / year
+ Drive consistent incident, problem, and change management across pods; lead resolution of high-severity escalations and root cause analysis.
Added 4 hours ago
AP/AR Associate
Victor Sierra Aviation
Baldwin City, KS
You’re a detail-oriented, analytical problem-solver who’s comfortable working at the intersection of accounting, technology, and operations. You bring hands-on experience with ERP systems…
Added 4 hours ago
M
Retail Sales Associate - Furniture/Mattresses/Rugs, Pheasant Lane - Full Time
Macy's
Nashua, NH
- Full-time
Ensure high-level of customer service through problem-solving and customer-focused solutions, such as converting a return into an exchange and expediting resolution of delivery issues

Coloplast A/S

Regulatory & Payer Operations Support Specialist

Ventura, CA, United States

$24.07 USD / hour

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Job details

Pay: $24.07 USD / hour
Experience: Minimum 2 years' experience with Medicaid, Medicare, payer operations, revenue cycle, healthcare reimbursement, or regulatory compliance.
Posting language: English
Posted: Nov 4, 2026

Original job description

The Regulatory & Payer Operations Support Specialist serves as the office-level regulatory, payer, and operational support lead. The role is responsible for survey readiness, Medicaid and payer coordination, and will provide operational support with insurance verification, prior authorization support, audit response coordination, medical records retrieval, and office administrative operations. This position partners with clinical, operational, revenue cycle, and regulatory teams to ensure compliance, operational efficiency, and exceptional service to patients and customers.

Major Areas of Accountability

Regulatory Affairs

Serve as the local point of contact for CMS, Medicaid, accreditation, and payer surveys.
Maintain continuous survey readiness and compliance with regulatory, licensing, accreditation, and company requirements.
Coordinate mock surveys, compliance audits, and readiness assessments; communicate findings and corrective actions.
Maintain regulatory documentation and support office leadership in compliance monitoring.

Medicaid & Payer Relations

Monitor and interpret Medicaid regulations, payer policies, and reimbursement requirements within assigned territory.
Act as a liaison between the local office, Medicaid agencies, managed care organizations, payer representatives and the Managed Care Access and Credentialing teams.
Works cross-functionally to support issue resolution related to eligibility, authorizations, documentation, reimbursement, and claims.
Provide updates regarding payer requirements and regulatory changes.

Insurance Verification & Prior Authorization Support

Conduct insurance eligibility and benefit verification for new and existing patients.
Submit, track, and follow up on prior authorization requests with government and commercial payers.
Communicate authorization status and requirements to patients, providers, and internal stakeholders.
Maintain accurate documentation of eligibility determinations, authorization approvals, denials, and appeals.

Audit Response & Medical Records Support

Coordinate collection of supporting documentation for internal audits, payer audits, and regulatory reviews.
Perform medical record chase activities with provider offices and clinicians to obtain required records.
Ensure completeness and accuracy of records prior to submission.
Maintain audit trackers and monitor response deadlines.

Office Administrative Support

Coordinate administrative activities supporting daily office operations and compliance.
Support onboarding, training coordination, and personnel documentation management.
Maintain office records, logs, reports, equipment, and office resources.
Promote ethical conduct and compliance with company policies and applicable regulations.
Perform other duties as assigned.

Basic Qualifications

Minimum 2 years' experience with Medicaid, Medicare, payer operations, revenue cycle, healthcare reimbursement, or regulatory compliance.
Experience with insurance verification, prior authorization processing, or payer communications.
Experience supporting audits, surveys, compliance reviews, or regulatory inspections.
Strong Microsoft Office skills and documentation management capabilities.
Excellent communication, organization, and problem-solving skills.
Ability to manage multiple priorities in a fast-paced healthcare environment.
Occasionally, employees currently recognized as high performers through recent performance evaluations, or employees with current demonstrated productivity leadership compared to other employees on existing metrics may be asked to engage in overtime.
Must have one year or more paid experience related to the distribution or dispensing of prescription drugs or prescription devices.
Must be able to provide a physical or electronic copy of your High school diploma or equivalent.

Preferred Qualifications

Associate or bachelor's degree in healthcare administration, Business Administration, Public Health, Regulatory Affairs, or related field.
Experience in DMEPOS, HME, home health, or other regulated healthcare environments.
Knowledge of CMS, Medicaid, accreditation, and payer requirements.
Experience with medical record retrieval, audit responses, claims support, and reimbursement processes.
Familiarity with Medicaid managed care organizations and multi-state operations. At Coloplast, we believe in recognizing and rewarding the contributions of our employees. Our total rewards package is designed to support your well-being, foster your professional growth, and ensure a healthy work-life balance. Here is some of what you can expect: Health and Wellness: Comprehensive medical, dental, and vision insurance plans to keep you and your family healthy. Plus, access to company sponsored wellness programs and mental health resources, paid leave of absence for qualifying events and generous paid parental leave for both birthing and non-birthing parents. Financial Security: A competitive 401(k) plan with company match that vest immediately, financial planning services to help you secure your future, and corporate discount programs for goods and services. Work-Life Balance: Generous paid time off, flexible work hours, and flexible work arrangement options to help you balance your personal and professional life may be available. Professional Development: Opportunities for continuous learning and career advancement through training programs, mentorship, and tuition reimbursement. Recognition and Rewards: Recognition programs to celebrate achievements and contributions, including peer recognition, bonuses, awards, and special events. Community and Culture: A supportive work environment where everyone feels valued, and has a sense of belonging. Participate in team-building activities, volunteer opportunities, and company-sponsored events. Sustainability strategy that outlines our ambitions for how to run our company in a more sustainable way. Competitive Compensation: The starting hourly rate for this position is $24.07. Hired candidates may be eligible to receive additional compensation for applicable experience and may also be eligible for bonuses and/or incentives. Actual compensation is influenced by a variety of factors including but not limited to skills, experience, qualifications, and geographic location.

Comfort Medical provides an extensive selection of name brand catheter and ostomy supplies to thousands of customers nationwide. Our attention to detail, unmatched customer service, and dedication to helping our customers live happier, healthier lives are just a few of the many reasons we are one of the fastest growing catheter and ostomy supply companies in the nation!

Comfort Medical employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.

Comfort Medical is committed to a policy of Equal Employment Opportunity (EEO) which means we employ and promote individuals based on their merits, regardless of race, color, religion, sex, national origin, age, disability, veteran status, pregnancy, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status, status with regards to public assistance or any other protected classification.

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