Senior Contract Definition Analyst - Healthcare - Remote

Overview

The Senior Contract Definition Analyst plays a critical role in the implementation and maintenance of hospital payer contracts within Experian Health's Contract Manager system, ensuring accurate modeling of reimbursement methodologies to support valuation of hospital claims and patient estimates.

In Short

• Collaborate with senior team members to process new client implementations.
• Manage routine maintenance cases while ensuring compliance with enterprise standards.
• Analyze and interpret complex contract provisions and reimbursement rates.
• Research payer websites and regulatory sources to stay current on rules and policies.
• Validate system-generated valuations against client-submitted claims.
• Ensure contract terms are accurate and implemented in alignment with client intent.
• Respond to valuation-related support cases within defined SLAs.
• Participate in internal and client meetings for project alignment.
• Contribute to process improvement initiatives.

Requirements

• 4+ years' experience in the hospital industry.
• Familiarity with hospital billing and payer contracting.
• Knowledge of facility reimbursement models used by commercial payers.
• Proficiency in coding systems including CPT, HCPCS, DRG, and ICD-10.
• Bachelor's degree in Healthcare Administration, Finance, Accounting, or Business preferred.

Benefits

• Great compensation package and bonus plan.
• Core benefits including medical, dental, and vision.
• Flexible work environment with remote options.
• Flexible time off including volunteer time off.
• Explore all exciting benefits on the company benefits site.