Payer Integration Specialist

United StatesRemoteFull-timemid

OtherIntegration Specialist

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Quick Summary

Overview

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Payer Integration Specialist based in United States.

Technical Tools

OtherIntegration Specialist

The Payer Integration Specialist will help expand access to mental health services by enabling seamless connectivity with health plans and health systems.
This role sits at the intersection of healthcare operations, technical integrations, billing, and customer implementation.
You will translate complex payer requirements into practical implementation steps, automated workflows, and reliable system configurations.
Working closely with internal and external stakeholders, you will help ensure eligibility, claims, and billing processes operate accurately and efficiently.
The role offers the opportunity to work across Sales, Product, Engineering, Billing Operations, and Customer Success in a highly collaborative environment.
You will manage integration projects, troubleshoot technical issues, and proactively address risks throughout the customer lifecycle.
This is an ideal opportunity for a healthcare integration professional who enjoys solving complex problems and improving operational experiences at scale.

Coordinate with health plans and external partners to establish and maintain technical and operational connectivity for standard and customized integrations.
Translate payer-specific requirements into clear implementation steps, workflows, configurations, and deliverables for internal teams.
Serve as the primary point of contact for health plan integration setups, with a focus on eligibility, claims, billing, and related workflows.
Implement, configure, test, and troubleshoot technical integrations involving health plans and health systems.
Participate in customer and partner kickoff meetings, acting as a liaison between external stakeholders and internal technical and operational teams.
Collaborate closely with Sales, Product, Engineering, Payer Billing Operations, Customer Success, and other teams to maintain alignment throughout the customer journey.
Develop and manage project plans, timelines, milestones, dependencies, and deliverables to ensure integrations are completed accurately and on schedule.
Assist with annual benefit updates and ongoing configuration changes to maintain data integrity and accurate payer workflows.
Identify potential integration risks, investigate issues, and proactively drive problems toward resolution.
Contribute to additional integration and operational initiatives as needed to support business growth and improve payer connectivity.

Requirements

~1 min read

3+ years of professional experience in a high-growth, fast-paced environment, preferably within healthcare, health technology, payer operations, or a related field.
Deep understanding of health plan structures, payer operations, claims billing, utilization management, and healthcare administrative workflows.
Hands-on experience with healthcare integration standards and workflows such as RTE 270/271, claims 837, accumulators, or comparable payer connectivity technologies.
Familiarity with operational and project management tools such as Asana and Salesforce is preferred.
Strong project management skills, including the ability to manage multiple workstreams, timelines, dependencies, and competing priorities.
Exceptional written and verbal communication skills, with the ability to work effectively with both technical and non-technical stakeholders.
Strong analytical and problem-solving capabilities, with the ability to navigate ambiguity and identify practical solutions.
Proactive, organized, and detail-oriented approach to managing integration projects and resolving issues.
Collaborative mindset and demonstrated ability to lead, coordinate, and support multiple stakeholders across functions.
Ability to anticipate risks, maintain accountability, and drive initiatives through to successful completion.