Healthcare Contract Analyst

Job Summary

Analyzing and implementing professional payer contracts, the full-time Medical Group Contract Definition Analyst will work remotely to support the valuation of medical group claims and patient estimates while interpreting payer contracts and reimbursement methodologies.

Key responsibilities:

• Analyze and define medical group contracts for various payer types, including Medicare and Medicaid
• Interpret payer contracts and fee schedules to ensure accurate system configuration and reimbursement
• Validate claim and estimate valuations, troubleshoot discrepancies, and respond to support cases

Required qualifications:

• 4+ years of healthcare industry experience with professional/medical group payer contracts and reimbursement
• 4+ years of knowledge in professional reimbursement methodologies, including RBRVS and fee schedules
• 4+ years of experience with claim processing guidelines and payer-specific reimbursement arrangements
• 4+ years of advanced Excel expertise, capable of performing complex functions
• Bachelor's degree in Healthcare Administration, Business Administration, or a related field is beneficial