Payer Analyst

Job Summary

A company is looking for a Payer Analyst to educate internal teams on payer guidelines and resolve claim issues.

Key Responsibilities

• Understand and navigate payer guidelines and contract terms
• Identify and escalate claim issues with payers and stakeholders
• Analyze data to monitor payer trends and operational processes

Required Qualifications

• High school diploma with 4-6 years of relevant experience
• Proficiency in healthcare reimbursement pricing structures and methodologies
• Excellent knowledge of revenue cycle operations, especially with managed care and commercial payers
• Ability to implement process improvements based on leadership directives
• Experience in managing escalated issues and complaints