Medical Group, Contract Definition Analyst

📋 Description

• Analyze, implement, and maintain professional payer contracts within Contract Manager system.
• Model contract terms and support valuation of medical group claims and patient estimates using
• Define and analyze medical group contracts for Medicare, Medicaid, Workers' Compensation, Medicare

🎯 Requirements

• 4+ years in healthcare with payer contracts, reimbursement, billing, claims management, or
• 4+ years knowledge of professional reimbursement methodologies (RBRVS, physician fee schedules).
• 4+ years experience with carve-outs, drug, DME, and laboratory pricing and payer-specific
• 4+ years experience with claim processing guidelines, payer edits, CPT/HCPCS/ICD-10 coding.
• 4+ years Advanced Excel (complex functions).
• Bachelor's degree in Healthcare Administration or related field beneficial.

🎁 Benefits

• Great compensation package and bonus plan.
• Core benefits: medical, dental, vision, and 401K matching.
• Flexible work environment, remote capability.
• Flexible time off, volunteer time off, vacations, holidays.
• Explore all benefits at https://myexperianbenefits.com/