Hospital Contract Definition Analyst

Responsibilities:

• Use knowledge of reimbursement methodologies to analyze, define and maintain hospital payer contracts.
• Analyze complex contract provisions and reimbursement rates submitted by clients to identify all necessary terms for accurate system configuration.
• Research payer websites and regulatory sources (CMS, state Medicaid, commercial payers) to stay current on adjudication rules and reimbursement policies.

Qualifications:

• 3+ years experience in the hospital industry.
• 2+ years direct experience with hospital billing, claims management (facilities, appeals), and payer contracting.
• 2+ years in-depth knowledge of facility reimbursement models used by commercial payers, Medicare, and Medicaid for both inpatient and outpatient services.

Benefits:

• Great compensation package and bonus plan
• Core benefits including medical, dental, vision, and matching 401K, and life and disability insurance
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays