Payment Administration & Review Subject Matter Expert

Abbott

  • Orlando, FL
  • $75,300-150,700 per year
  • Permanent
  • Full-time
  • 2 days ago
Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues serve people in more than 160 countries.Working at AbbottAt Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to:
  • Career development with an international company where you can grow the career you dream of.
  • Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year.
  • An excellent retirement savings plan with a high employer contribution.
  • Tuition reimbursement, the
student debt program, and education benefit - an affordable and convenient path to getting a bachelor’s degree. * A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune.
  • A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists.
The OpportunityThis position works out of our Orlando, FL location in the Heart Failure Division. In Abbott’s Heart Failure (HF) business, we’re developing solutions to diagnose, monitor and manage heart failure, allowing people to restore their health and get on with their lives.The Payment Review & Administration SME is responsible for leading the review and analysis of healthcare payments received to ensure proper application and accuracy. This role coordinates with insurance payers and internal departments to resolve payment discrepancies, patient refunds, and prepares documentation for internal, QC remediation, and external payer audits. The SME will support training and onboarding initiatives, assist in developing and enhancing standard operating procedures, and contribute to process improvement initiatives across the payment review and administration functions.What You’ll Work OnAnalyze and validate payment data to ensure accurate posting and identify underpayments, overpayments, or contractual discrepancies.Coordinate with insurance payers to resolve payment variances and request necessary adjustments, refunds, or supporting documentation.Prepare, validate, and submit patient refund packets in accordance with payer policies and company guidelines.Develop and maintain internal documentation to support payer audits, including compiling remittance advice, EOBs, medical documentation, and internal reconciliations.Act as a subject matter expert and resource for escalated payment or refund questions across departments.Facilitate training sessions for new and existing staff, ensuring consistent understanding of policies, tools, and workflows.Collaborate with cross-functional teams (Billing, Collections, Cash Posting, and Compliance) to identify and implement workflow enhancements.Assist in the creation, documentation, and refinement of standard operating procedures (SOPs) related to payment review, administration, and audit support.Monitor trends in denials, refunds, and payment patterns to proactively identify areas of concern or improvement.Support quality assurance efforts by auditing payment records and refund documentation for compliance and accuracy.Collaborate with RCM department leads to review QC remediation items, ensure timely resolution, and document any identified process gaps or necessary changes.Data collection and reportingMaintain payer review trending analytics and report to the management.General supportPerform other duties as assigned.Required Qualifications
  • Bachelor’s degree or Health Care Administration, Finance/Accounting or Minimum 10 years of experience
  • Revenue Cycle experience
  • Knowledge of Accounting & Finance with Microsoft Excel and Power Point for reporting.
Preferred Qualifications
  • Experience in Durable Medical Equipment (DME)Industry preferred
Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives:Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity.Connect with us at , on Facebook at , and on Twitter @AbbottNews.The base pay for this position is $75,300.00 – $150,700.00. In specific locations, the pay range may vary from the range posted.

Abbott