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.
Independently manages routine maintenance cases, ensuring compliance with enterprise standards and client expectations.
Support implementation teams with deployment of Experian's ClaimSource revenue cycle management system.
Analyze internal processes and recommend improvements to enhance efficiency, automation, and effectiveness.
Build strong relationships with clients and implementation/service teams; participate in regular client calls.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. We operate across a range of markets and have a team of 23,300 people across 32 countries, investing in people and new advanced technologies to unlock the power of data and to innovate.
Support current Claim Source Review internal process, recommend and develop changes to improve systems efficiency, automation, and effectiveness
Document and communicate complex solutions to internal and external clients promptly
Assess project complexity and estimate development and implementation timeframe
Experian is a global data and technology company, powering opportunities for people and businesses around the world. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), they have a team of 23,300 people across 32 countries and corporate headquarters are in Dublin, Ireland.
Manage end-to-end provider contracting and credentialing processes.
Maintain accurate and up-to-date provider records and documentation.
Assist with billing setup for newly credentialed providers.
Understood Care helps older adults by providing them with Medicare-covered patient advocacy services. They pair each person with a dedicated advocate who helps them navigate care, reduce costs, and make confident healthcare decisions.
Review payer financial reconciliations for accuracy and adherence to agreed-upon methodologies.
Support for the development and deployment of audit procedures applied to payer data sets.
Partner across teams and with payers to resolve data discrepancies.
Aledade empowers independent primary care practices to deliver better care to their patients and thrive in value-based care. They are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Initiate, negotiate, and execute contracts with physicians and healthcare providers.
Analyze financial impacts and maintain documentation within a tracking system.
Advise leadership on functional strategies regarding provider contracts.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. They identify the top-fitting candidates and share this shortlist directly with the hiring company.
Participate in end-to-end implementation activities.
Develop an understanding of Experian Health's product suite and apply best‑practice workflows.
Facilitate requirements gathering, workflow mapping, configuration reviews, and user acceptance testing.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. A FTSE 100 Index company listed on the London Stock Exchange, they have a team of 23,300 people across 32 countries and corporate headquarters in Dublin, Ireland.
Manages the entire lifecycle of payer enrollment, credentialing, and re-enrollment of healthcare providers and facilities.
Maintains provider databases, ensuring accurate, timely submission of documentation to secure billing privileges and network participation.
Resolves claim denials, verifying insurance and performing billing related tasks to ensure timely and accurate reimbursement.
Plumas District Hospital (PDH) provides compassionate care with exceptional customer service. They are located in Quincy, California with a team that puts community first.
Maintain the AthenaIDX practice management system.
Translate business needs into system updates.
Troubleshoot errors and support third-party vendors.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Oversee provider credentialing, provider licensing, payer contracting, and network expansion.
Lead end-to-end provider credentialing, provider licensing and recredentialing for MDs and NPs.
Manage relationships with credentialing and contracting vendors.
Sunrise Group is building the future of sleep health by combining innovative technology with expert care. They are a fast-growing team across the US and Europe, backed by more than $50M (€46M) from leading investors including Amazon’s Alexa Fund, Eurazeo, Kurma, and VIVES.
Conduct in-depth analysis of claim payments, identifying trends and patterns for cost avoidance through internal and external collaboration.
Ensure medical claims comply with guidelines, contracts, and standards while detecting billing inefficiencies and recommending corrective actions.
Provide data-driven recommendations to management on payment-affecting issues, supporting necessary system and policy updates and provider education.
BCBSRI is dedicated to serving Rhode Islanders by providing access to high-quality, affordable, and equitable care. They actively support associate well-being and work/life balance, fostering a culture of belonging where diverse perspectives are valued and employees are equipped for success.
Conduct audits of payer processed claims to verify accurate reimbursement.
Conduct post-implementation Care Center audits following the audit policy.
Assist the Manager, RI, in leading initiatives that drive efficiency.
Privia Health is a technology-driven physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices. Their platform consists of scalable operations and cloud-based technology to reduce healthcare costs and improve patient outcomes.
Review and analyze CDM data to ensure accuracy and compliance.
Conduct regular audits to identify discrepancies and areas for improvement.
Work with clinical, billing, and coding teams to resolve charge capture issues.
LCMC Health is a community-focused healthcare provider deeply rooted in New Orleans, Louisiana. They are committed to providing exceptional care and education, with a culture that celebrates authenticity, equity, and inclusion.
Lead support for business initiatives through data analysis and user acceptance testing
Identify and analyze user requirements to improve processes
Perform detailed analysis on projects and recommend business solutions
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Assess and Analyze daily charge activity for assigned area.
Works with the Revenue Integrity Manager on quality assurance and auditing of charge activity within IHIS.
Anesthesia Reconciliation; analysis of charge sessions for submission to Central Coding Department for revenue capture.
Ohio State University Physicians (OSUP) provides exceptional patient care while fostering a collaborative work environment through over 100 outpatient center locations. OSUP fosters a culture grounded in the values of inclusion, empathy, sincerity, and determination, with a team including more than 1,800 employees.