Full-Time Contract Definition Analyst II

Contract Definition Analyst II - Remote

This role is remote, with 10% travel.

Key Responsibilities:

• Define payer contracts (Medicare, Medicaid, Workers Compensation, Commercial).
• Research payer websites for adjudication rules.
• Review client claims/estimates for accuracy.
• Participate in internal/client meetings.
• Model payer contracts for valuing claims.
• Audit implementations.
• Respond to valuation-related support cases.

Experience Requirements:

• 2+ years experience in the physician/hospital industry.
• Direct experience with payer contracts, reimbursement, and adjudication rules (Medicare, Medicaid, Commercial).
• 2+ years physician/hospital billing, payer contracting, claims management, scrubbing, and applying edits (Medicare, Medicaid, Commercial).
• 2+ years Medicare adjudication methods (physician, inpatient, outpatient).
• 2+ years experience with relevant coding conventions (CPT, HCPCS, DRG, Revenue, Occurrence, ICD-10).

What is the last date for applying to the job?

Which countries are accepted for this remote job?