Reimbursement Technical Analyst

Job Summary

A company is looking for a Reimbursement Technical Analyst.

Key Responsibilities

• Review health plan-specific reimbursement policies for compliance with contractual and regulatory requirements
• Create and maintain table-based rules using health plan disclosures and industry standards
• Manage and update the Claims Reimbursement database to ensure edit rules and tables remain current

Required Qualifications

• Familiarity with medical/clinical nomenclature
• Experience with CPT, CCI, CMS, or health plan-specific rules for claim payment
• Knowledge of health plan/provider contracting and fee schedules
• Proficiency in Microsoft Excel and Word
• Bachelor's degree in a healthcare-related field (preferred)