Hospital Contract Definition Analyst, Healthcare (Remote)

Responsibilities:

• Use knowledge of reimbursement methodologies to analyze, as well as, 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 to stay current on adjudication rules and reimbursement policies.

Qualifications:

• 3+ years' experience in the hospital industry, with direct involvement in payer contracts, facility reimbursement methodologies, and adjudication rules.
• 2+ years' direct experience with hospital billing, claims management, 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.
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays.