Contract Definition Analyst

🕒 Agosto 18

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $63.964 - $110.872 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🧐 Analista

🦅 Patrocina Visto H1B

Esta empresa já patrocinou vistos H1B no passado.

👻 Score fantasma 0%

O que significa: quão provável esta vaga está aberta sem contratação ativa.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Como pontuamos: tempo em aberto, republicações, vagas abertas vs tamanho do time, rapidez para fechar vagas, e se o salário está divulgado.Observação: é uma estimativa de dados públicos, não um julgamento da empresa. Vagas reais podem ter pontuação alta, então use como uma dica, não como um fato.

Candidatar-se

Encontrar Vagas Remotas Similares

Configurar Alerta de Email para Novas Vagas

📊 Verifique sua pontuação de currículo para esta vaga

Melhore suas chances de conseguir uma entrevista verificando sua pontuação de currículo antes de se candidatar.

Enviar Currículo

Experian

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1996

💼 Consultoria

📣 Marketing

📦 Logística

Consulting • Marketing • Logistics

A Experian libera o poder dos dados para criar oportunidades para consumidores, empresas e a sociedade.

Descrição

• Analyze and define medical group contracts for Medicare, Medicaid, Workers' Compensation, Medicare Advantage, Managed Medicaid, and Commercial Payers • Interpret payer contracts, fee schedules, reimbursement provisions, and supporting documentation for accurate system configuration • Apply professional reimbursement methodologies, including RBRVS, fee schedules, carve-outs, drug, DME, and laboratory pricing • Research CMS, state Medicaid, and commercial payer resources to understand reimbursement policies, claim processing guidelines, and payer edits • Validate and troubleshoot claim and estimate valuations, research discrepancies, and resolve issues • Respond to valuation-related support cases within established timeframes • Participate in client and internal meetings to clarify contract requirements and resolve issues • Contribute to quality and process improvement plans while maintaining current knowledge of evolving reimbursement methodologies and payer policies

🎯 Requisitos

• 4+ years' healthcare industry experience involving professional/medical group payer contracts, reimbursement, billing, claims management, or adjudication • 4+ years' knowledge of professional reimbursement methodologies, including RBRVS and physician fee schedules • 4+ years' experience with carve-outs, drug, DME, and laboratory pricing and payer-specific reimbursement arrangements • 4+ years experience with claim processing guidelines, payer edit policies, and professional coding conventions, including CPT, HCPCS, modifiers, place of service, and ICD-10 diagnosis codes • 4+ years' Advanced Excel (can perform complex functions) expertise • Experience with Contract Manager or similar healthcare contract modeling applications • Bachelor's degree in Healthcare Administration, Business Administration, or a related field is beneficial

🏖️ Benefícios

• Flexible Time Off: 15 Days • Great compensation package and bonus plan • Core benefits including medical, dental, vision, and matching 401K • Flexible work environment, ability to work remote • Flexible time off including volunteer time off, vacation, sick and 12-paid holidays