Remote Healthcare Payer Contract Definition Analyst II

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