Payer Integration Solutions Analyst

📋 Description

• Gather, analyze, validate, and document customer, payer, business, and technical requirements, and
• Independently own assigned payer integration and configuration work from requirements definition
• Configure and maintain payer-specific billing rules, claim submission logic, enrollment
• Analyze and troubleshoot implementation and production issues; identify root causes; evaluate
• Partner with Implementation, Product, Engineering, Operations, payer, and client-facing teams, and
• Execute testing, validation, and quality assurance activities to confirm configurations and

🎯 Requirements

• Four or more years of relevant experience in healthcare revenue cycle, payer operations, claims
• Working knowledge of Medicaid and managed care organization revenue cycle and payer processes
• Working knowledge of healthcare electronic data interchange and X12 standards, including 837, 835
• Experience interpreting payer specifications, companion guides, implementation requirements, and
• Experience working with configuration-driven software platforms and managing multiple
• Strong analytical and troubleshooting skills, including the ability to identify root causes

🎁 Benefits

• Competitive health plans
• Paid time-off
• Company paid holidays
• 401K retirement program with a Company elected match
• Other company sponsored programs