Payment Insight Analyst

Job Summary

Reviewing internal and client systems, the full-time Payment Insight Analyst will analyze healthcare claims and apply contractual terms to ensure accurate claim pricing while supporting compliance initiatives in a remote environment.

Key responsibilities

• Review internal and client systems to determine eligibility and payment methodologies for healthcare claims
• Analyze claim documentation to identify accurate repricing approaches based on contractual terms
• Partner with internal audit teams to support compliance and quality improvement initiatives

Required qualifications

• Minimum one-year professional experience in a healthcare, insurance, or claims processing environment preferred
• High school diploma or GED required; Associate's or Bachelor's degree in Business, Healthcare Administration, Finance, or a related field preferred
• Relevant coursework or training in healthcare claims, insurance, or data analysis is a plus
• Proficiency with computer systems and basic office software (e.g., Microsoft Excel, Word, Outlook)
• Ability to interpret contracts, guidelines, and client requirements