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Payer Payment & Reimbursement Analyst
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Job Description
- Req#: 5001176904506
Employer Industry: Healthcare Payment and Reimbursement
Why consider this job opportunity:
- Competitive salary with additional position-specific incentives
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package including health insurance and fully paid life and disability insurance
- Supportive work environment focused on work-life balance and professional development
- Chance to make a significant impact on healthcare administrative costs for federal agencies, payers, and providers
- Work in a company recognized as one of the Best Places to Work
What to Expect (Job Responsibilities):
- Configure and maintain payment, pricing, and contract logic within healthcare reimbursement systems
- Analyze vendor bulletins, regulatory updates, and system changes for impact assessment
- Review and evaluate healthcare data sets to identify trends and required changes
- Collaborate with government agencies to clarify reimbursement and payment policies
- Develop complex Excel models to validate and support payment methodologies
What is Required (Qualifications):
- 3-4 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 and Prospective Payment Systems (PPS)
- Strong analytical and critical-thinking skills with high attention to detail
- Ability to communicate effectively with diverse internal and external stakeholders
How to Stand Out (Preferred Qualifications):
- Proficiency in Microsoft Office applications including Excel and Access
- SQL reporting experience
- Knowledge of claims adjudication and payment workflows
- Experience using web-based research tools and regulatory resources
- Experience configuring TriZetto Facets NetworX or Optum Rate Manager
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