Job Summary
A healthcare company has an open position for a Remote Healthcare Payer Contract Definition Analyst II.
Core Responsibilities Include:
- Defining payer contracts
- Researching payer websites for adjudication rules as well as continuous learning
- Reviewing client’s claims or estimates to verify accuracy of valuation
Applicants must meet the following qualifications:
- Bachelor’s degree or greater in related field, or equivalent combination of education and experience
- 5 years’ experience working in the physician and/or hospital industry
- Physician and/or Hospital billing and/or payer contracting as well as claims management background
- Experience in Claims Scrubbing and application of edits
- In depth first-hand knowledge with Medicare adjudication methods for Physician
- Demonstrated knowledge of coding conventions and the function of each
