Payer Operations Specialist, Spring Health

• 1–3 years of experience in healthcare operations, revenue cycle, payer integrations, or data analysis
• Strong analytical skills with working knowledge of Excel/Google Sheets
• Excellent attention to detail, organizational skills, and follow-through
• A systems thinker who’s eager to learn, contribute, and grow within a fast-paced environment
• Strong written communication skills for internal documentation and reporting
• Familiarity with payer setup workflows or integration processes
• If this role excites you, we encourage you to apply

Desirable

• Reporting to the Senior Manager, Payer Operations, the Payer Operations Specialist will manage and support payer partners to ensure smooth operational performance
• This full time, remote role is part of the Payer Operations team and plays a critical role in enabling clean claims, optimizing payer workflows, and driving scalable improvements across revenue operations
• You'll collect, analyze, and interpret clinical, operational, and financial data to assess payer performance and trends
• Monitor KPIs such as DSO, denial volume, and claim routing accuracy, flagging anomalies or discrepancies to the broader team
• Assist with the creation and maintenance of automated and self-refreshing KPI dashboards
• Support audit preparation and reconciliation efforts by pulling reports and validating data sets
• Collaborate with IC3+ team members on new integrations, payer escalations, or special projects through research, timeline tracking, and administrative setup
• Coordinate project milestones, risks, and deliverables, surfacing issues when timelines or inputs are at risk
• Facilitate information flow and handoffs across internal teams including Billing, RCM, Product, and Legal
• Maintain SOPs, payer playbooks, internal how-to guides, and reference materials
• Standardize and centralize payer account information (e.g., routing rules, modifier requirements, prior auth logic)
• Document meeting notes, decisions, and follow-ups to ensure accountability and next steps
• Execute recurring workflows that support clean claims, reduced DSO, and payer performance health
• Translate front-line payer knowledge into scalable process improvements
• What success looks like:
• Clean, timely claim submissions across assigned payer accounts
• DSO reduction and denial volume trending downward quarter-over-quarter
• KPI dashboards updated weekly with high data accuracy
• SOPs and payer documentation maintained and up to date across all assigned accounts
• Cross-functional teams aligned on launch readiness and ongoing workflows