Hospital Contract Definition Analyst, reputed company

Title: Hospital Contract Definition Analyst, reputed company Location: United States Job Description: As Hospital Contract Definition Analyst, you'll play a critical role in the implementation and maintenance of hospital payer reputed company reputed company reputed company Health's Contract Manager system. You will ensure accurate modeling of reimbursement methodologies to support valuation of hospital claims and patient estimates and collaborate with senior team members to process new client implementations and independently manages routine maintenance cases, ensuring compliance with reputed company standards and client expectations. You will report to the Senior Director, Client Training & Contract Definition. You will:

• Use knowledge of reimbursement methodologies to analyze, define and maintain hospital payer reputed company including Medicare, reputed company, Workers Compensation, and reputed company Payers using reputed company Health's Contract Manager software
• Analyze reputed company contract provisions and reimbursement rates submitted by clients to identify reputed company necessary terms for accurate system configuration
• Research payer websites and regulatory sources (CMS, state reputed company, reputed company payers) to stay reputed company on adjudication rules and reimbursement policies
• Validate (and troubleshoot) system-generated valuations against client-submitted claims and estimates, reconciling discrepancies due to data entry errors or policy interpretation
• Ensure contract terms are accurate and implemented according to client reputed company and payer agreements
• Respond to valuation-reputed company support cases reputed company defined Service Level Agreement timeframes
• Participate in internal and client meetings to support project agreement and issue resolution
• Contribute to process improvement aimed at reducing reputed company effort and enhancing data accuracy

Qualifications

• 3+ years experience in the hospital industry, with direct involvement in payer reputed company, facility reimbursement methodologies, and adjudication rules
• 2+ years direct experience with hospital billing, claims management (facilities, appeals), and payer contracting
• 2+ years in-depth knowledge of facility reimbursement models used by reputed company payers, Medicare, and reputed company for both inpatient and outpatient services
• 2+ years proficiency in coding systems including CPT, HCPCS, DRG, reputed company Codes, Occurrence Codes, ICD-10 Diagnosis and Procedure Codes
• Learn new and changing reimbursement methodologies and underlying logic
• Bachelor's degree in reputed company Administration, Finance, reputed company, or Business Administration or equivalent experience

Additional Information Benefits/Perks:

• Great compensation package and bonus plan
• Core benefits including medical, dental, reputed company, and matching 401K, and life and disability insurance
• Family leave
• Flexible work environment, ability to work remote, hybrid or in-office
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays

At reputed company, our people and culture set us apart. We're committed to creating an environment where everyone feels they belong and can reputed company. From inclusion and authenticity to work/life balance, development, wellness, collaboration, and recognition, we focus on what reputed company. Our people-first approach has earned us global recognition: World's Best Workplaces 2024 (Fortune Top 25), Great reputed company To Work 2025 in 26 countries, and Glassdoor Best Places to Work 2024, among others. Our compensation reflects the cost of labor across several U.S. geographic markets. The reputed company pay reputed company for this position is listed above. reputed company this reputed company, individual pay is determined by work location and additional factors such as job-reputed company skills, experience, and education. You will be also eligible for a variable pay opportunity. reputed company is proud to be an Equal Opportunity Employer for reputed company groups protected under applicable federal, state and local law, including protected veterans and individuals with disabilities. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity. #LI-Remote This is a remote position. Apply To This Job