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FileImport - Signature Performance
Payer Payment & Reimbursement Analyst - Remote/Nationwide
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What they do
A Healthcare Analyst is responsible for compiling important medical data through the use of computer-based applications, within a health care organization or hospital. Responsible for gathering, compiling, modeling, validating, and analyzing data needed by the organization.
$94,441 / year median in the U.S.
-2% projected decline
Job Description
Payer Payment & Reimbursement Analyst - Remote/Nationwide
This is a remote based position. Applicants can be located nationwideBack Payer Payment & Reimbursement Analyst #2861 United States X Facebook LinkedIn Email Copy Position Description About YouThe Payer Payment and Reimbursement Analyst will work with the team members in healthcare payment & reimbursement methodologies, laws and regulations under the mentorship and guidance of the Project Manager.
Tell us about your experience with Payment and Reimbursement Methodologies.
Are you a team player and a self-motivator?
What is your experience with conducting business in a way that is credit to a company?
We are counting on you to manage multiple projects using your problem-solving skills.
We are looking for someone
Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About the PositionConfigure and maintain payment, pricing, and contract logic within healthcare reimbursement systems to ensure accurate claims adjudication.
Analyze vendor bulletins, regulatory updates, and system changes to assess impact on internal processes, products, and data systems.
Review and evaluate large healthcare data sets to identify trends, anomalies, and required system or process changes.
Interpret Medicare, VA, CHAMPVA, and TRICARE policies, including rulings, transmittals, bulletins, manuals, and physician fee schedule data files.
Collaborate directly with government agencies to clarify new or existing reimbursement and payment policies.
Translate reimbursement policy updates and payment methodology changes into clear, actionable business requirements for software design and system configuration.
Develop complex Excel models and formulas to validate, explain, and support payment methodologies.
Identify claim data characteristics required for testing pricing logic and configuration accuracy.
Partner with Developers, QA, Data, and Client Services teams to ensure requirements are implemented accurately and on schedule.
Create and execute test claims for development, UAT, QA, and configuration validation.
Perform configuration testing and troubleshoot pricing or payment discrepancies.
Maintain deep knowledge of company products, data, and services, including commercial contracting and reimbursement features.
Independently evaluate and resolve complex pricing and reimbursement issues while managing multiple priorities.
Core Competencies Strong analytical and critical-thinking skillsHigh attention to detail and qualityAbility to synthesize complex policy and data into practical solutionsEffective collaboration and communicationSelf-directed with strong prioritization skills Minimum Requirements3-4 years of professional experience in healthcare provider payment and reimbursement.
Working knowledge of healthcare billing, compliance, and payer reimbursement regulations.
Experience with professional and institutional payment fee schedules, including but not ...For full information see follow application link. This Company is an Equal Opportunity Employer, and does not discriminate on the basis of race, gender, ethnicity, religion, national origin, age, disability, veteran status, or on any other basis prohibited by law. Information on race, gender and national origin will only be used for statistical and recordkeeping purposes, and will not be used in making any employment decisions. All information provided will be kept separate from your expression of interest. Providing this information is strictly voluntary, and you will not be subjected to any adverse action or treatment if you choose not to provide this information. If you do not choose to answer these questions, we ask that you select "Decline to Identify" for each question. Thank you for your voluntary cooperation.
Tell us about your experience with Payment and Reimbursement Methodologies.
Are you a team player and a self-motivator?
What is your experience with conducting business in a way that is credit to a company?
We are counting on you to manage multiple projects using your problem-solving skills.
We are looking for someone
UNCOMMON.
What is uncommon about you?Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About the PositionConfigure and maintain payment, pricing, and contract logic within healthcare reimbursement systems to ensure accurate claims adjudication.
Analyze vendor bulletins, regulatory updates, and system changes to assess impact on internal processes, products, and data systems.
Review and evaluate large healthcare data sets to identify trends, anomalies, and required system or process changes.
Interpret Medicare, VA, CHAMPVA, and TRICARE policies, including rulings, transmittals, bulletins, manuals, and physician fee schedule data files.
Collaborate directly with government agencies to clarify new or existing reimbursement and payment policies.
Translate reimbursement policy updates and payment methodology changes into clear, actionable business requirements for software design and system configuration.
Develop complex Excel models and formulas to validate, explain, and support payment methodologies.
Identify claim data characteristics required for testing pricing logic and configuration accuracy.
Partner with Developers, QA, Data, and Client Services teams to ensure requirements are implemented accurately and on schedule.
Create and execute test claims for development, UAT, QA, and configuration validation.
Perform configuration testing and troubleshoot pricing or payment discrepancies.
Maintain deep knowledge of company products, data, and services, including commercial contracting and reimbursement features.
Independently evaluate and resolve complex pricing and reimbursement issues while managing multiple priorities.
Core Competencies Strong analytical and critical-thinking skillsHigh attention to detail and qualityAbility to synthesize complex policy and data into practical solutionsEffective collaboration and communicationSelf-directed with strong prioritization skills Minimum Requirements3-4 years of professional experience in healthcare provider payment and reimbursement.
Working knowledge of healthcare billing, compliance, and payer reimbursement regulations.
Experience with professional and institutional payment fee schedules, including but not ...For full information see follow application link. This Company is an Equal Opportunity Employer, and does not discriminate on the basis of race, gender, ethnicity, religion, national origin, age, disability, veteran status, or on any other basis prohibited by law. Information on race, gender and national origin will only be used for statistical and recordkeeping purposes, and will not be used in making any employment decisions. All information provided will be kept separate from your expression of interest. Providing this information is strictly voluntary, and you will not be subjected to any adverse action or treatment if you choose not to provide this information. If you do not choose to answer these questions, we ask that you select "Decline to Identify" for each question. Thank you for your voluntary cooperation.