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Payer Payment & Reimbursement Analyst
#2604
United States
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Position Description
ABOUT YOU
You are a person who loves to work with team members in healthcare payment &
reimbursement methodologies, laws and regulations. We need someone who will review
and analyze related vendor bulletins and updates for applicability and/or changes to
internal process, product or data systems. In the role of Payer Payment & Reimbursement
Analyst, you'll be responsible for performing system configuration tasks related to
contracts, pricing and reimbursement for healthcare claims. If you can put your signature
on this, we can't wait to hear from you!
- Tell us about your experience with Payer Payment & Reimbursement Analysis.
- Are you a team player and a self-motivator?
- What is your experience with conducting business in a way that is a credit to a
company? - We are counting on you to manage multiple projects using your problem-solving
skills. - We're looking for someone UNCOMMON. What is uncommon about you?
Are you highly committed? Are you team-oriented? Do you value professionalism, trust,
honesty, and integrity? If so, we can't wait to meet you.
ABOUT THE POSITION
The people you will work with are exceptional. Here is what you can look forward to, and why you'll LOVE YOUR DAYS.
- Perform system configuration tasks related to contracts, pricing and reimburse for
healthcare claims. - Review and analyze related vendor bulletins and updates for applicability and/or
changes to internal process, product or data systems. - Review and analyze healthcare data sets for applicability and/or changes to
changes to internal process, product or data systems. - Read and analyze Medicare, VA, CHAMPVA, TRICARE data and policy including
rulings, directorates, transmittals, bulletins, policy manual updates, physician fee
schedule (data file). - Contact various government entities to clarify new and existing policy.
- Interpret and deliver business requirements covering reimbursement updates and
payment policy changes and enhancement features for translation into software
design specifications. - Create detailed excel formulas to explain and prove complex payment
methodologies. - Identify claim data characters for testing of pricing configurations.
- Coordinate with developers, QA, data, client service and other team members to
ensure that business requirements are implemented accurately and timely. - Develop test claims for Developers, UAT and QA.
- Perform configuration testing.
- Develop and maintain proficiency in the Company's products (software, data) and
services, including commercial contracting features as related to the specific
area(s) assigned. - Experience working in the healthcare system with working knowledge of billing,
compliance, and payer reimbursement guidelines/regulations. - Ability to evaluate complex pricing issues for resolution
- Ability to work independently and prioritize workload according to project goals and
objectives - Core competencies include analytical thinking, information seeking, concern for
quality, teamwork.
Position Requirements:
- 3-4 years professional experience in provider payment/reimbursements for
healthcare, and familiarity with health care reimbursement systems and
methodologies. - Experience working in the healthcare system with working knowledge of billing,
compliance, and payer reimbursement guidelines/regulations. - Experience in healthcare provider professional and institutional payment and
reimbursement fee schedules (such as AWP, Physician Fee, DME/DEMPOS,
Ambulance, Lab, ESRD, Hospice, Dental, ASC, Anesthesia) - Experience working with Prospective Payment Systems, including (Acute Inpatient,
Hospital Outpatient, Skilled Nursing, Home Health, Long-Term Care, Inpatient
Rehabilitation, Inpatient Psychiatric) - Knowledge of Ambulatory Payment Classifications (APCs)
- Knowledge of Diagnosis Related Groups (DRGs)
- Knowledge of the integrated Outpatient Code Editor (I/OCE) program
- Able to collect, research, and understand diverse information, and translate it into
clear and concise written requirements. - Able to plan, prioritize, and balance the need for direction with self-motivated
efforts. - Strong interpersonal skills
- Working knowledge of provider types and specialties, including the applicable fee
schedule or reimbursement payment methodology for the provider type. - Ability to effectively communicate and collaborate with diverse internal and external
stakeholder groups and individuals. - SQL report experience preferred
Preferred Qualifications:
- Proficiency in using MS Office (Teams, Word, Excel, PowerPoint, Visio, Access)
software applications - Proficiency in using various Web-based and other research sources and tools
- Knowledge of claims adjudication and payment
- Proficiency in TriZetto Facets
- Proficiency in Optum Rate Manager
ABOUT US
You are uncommon. We are, too. We are looking for people to help us in our mission of
working hard at lowering healthcare administrative costs for federal government agencies,
payers, and providers. At Signature, our mission is to improve the health of our clients'
business and make the lives of the people we work with better. As we continue to
experience exponential growth, we are looking for uncommon individuals to enhance our
vision. We will continue to accomplish our mission by leading with our values of Passion,
Courage, Integrity, and Respect in all interactions, making us a consistent annual Best
Places to Work organization. We need uncommon leaders with uncommon qualities to
shape our uncommon culture and achieve our uncommon mission.
Security Requirements
- U.S. Citizenship, naturalized citizenship, or Permanent status is required for this position.
- All work on all position at Signature Performance must be completed in the continental United States, Alaska, or Hawaii.
Work Schedule
Monday through Friday, Standard Operating Business Hours |
Signature Performance
$47.60 / hr
Jan 08, 2026