Payer Operations Specialist jobs in United States
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Spring Health · 11 hours ago

Payer Operations Specialist

Spring Health is on a mission to revolutionize mental healthcare by removing barriers to access. The Payer Operations Specialist will manage and support payer partners, ensuring smooth operational performance and driving improvements across revenue operations.

Artificial Intelligence (AI)Health CareMental HealthmHealthWellness

Responsibilities

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

Qualification

Healthcare operations experienceData analysisKPI monitoringExcel/Google SheetsBI tools experienceSystems thinkingAttention to detailOrganizational skillsWritten communicationCollaboration

Required

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

Preferred

Experience using BI tools such as Looker or Tableau
Familiarity with payer setup workflows or integration processes
Exposure to healthcare claims systems or revenue operations tools

Benefits

Health, Dental, Vision benefits start on your first day at Spring.
Employer sponsored 401(k) match of up to 2% for retirement planning
A yearly allotment of no cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents.
We offer competitive paid time off policies including vacation, sick leave and company holidays.
At 6 months tenure with Spring, we offer parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents.
Access to Noom, a weight management program—based in psychology, that’s tailored to your unique needs and goals.
Access to fertility care support through Carrot, in addition to $4,000 reimbursement for related fertility expenses.
Access to Wellhub, which connects employees to the best options for fitness, mindfulness, nutrition, and sleep in one subscription
Access to BrightHorizons, which provides sponsored child care, back-up care, and elder care
Up to $1,000 Professional Development Reimbursement a year.
$200 per year donation matching to support your favorite causes.

Company

Spring Health

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Spring Health provides mental health solution for employers and health plans.

Funding

Current Stage
Late Stage
Total Funding
$466.5M
Key Investors
Generation Investment ManagementKinnevikTiger Global Management
2024-07-31Series E· $100M
2023-04-12Series D· $71M
2021-09-16Series C· $190M

Leadership Team

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April Koh
Co-Founder & CEO
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Adam Chekroud
Co-Founder, President
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Company data provided by crunchbase