Hospital Contract Definition Analyst, Healthcare

The Hospital Contract Definition Analyst plays a critical role in the implementation and maintenance of hospital payer contracts within Experian Health's Contract Manager system. You will ensure accurate modeling of reimbursement methodologies to support valuation of hospital claims and patient estimates and collaborate with senior team members to process new client implementations and independently manages routine maintenance cases, ensuring compliance with enterprise standards and client expectations. You'll use extensive knowledge of reimbursement methodologies to analyze, define, and maintain hospital payer contracts including Medicare, Medicaid, Workers Compensation, and Commercial Payers using Experian Health's Contract Manager software. You will analyze and interpret complex contract provisions and reimbursement rates submitted by clients to identify all necessary terms for accurate system configuration. You'll also research payer websites and regulatory sources (CMS, state Medicaid, commercial payers) to stay current on adjudication rules and reimbursement policies.