Payer Integration Solutions Analyst

HHAeXchange • Minneapolis, MN

1d • $70,000 - $80,000 • Hybrid

About The Position

The Payer Integration Solutions Analyst implements, maintains, and optimizes home care revenue cycle solutions, focusing on payer integrations and billing configuration. The role interprets payer business and technical requirements, translates them into scalable configurations, and independently manages assigned work through testing and production readiness. It partners across Implementation, Product, Engineering, Operations, and client-facing teams to support accurate data exchange and successful payer onboarding.

The position includes gathering and documenting requirements; configuring payer-specific billing rules, claim submission logic, enrollment requirements, reimbursement workflows, and integrations; troubleshooting implementation and production issues; and carrying out testing and quality assurance. The analyst supports payer onboarding, production-readiness activities, enhancements, ongoing optimization, and documentation and knowledge transfer. The role requires meeting service-level agreements, delivery standards, and internal procedures.

This is a full-time, exempt, benefits-eligible position with a base salary range of $70,000–$80,000 per year, excluding variable compensation. The employee must work on-site three days per week in the New York, Miami, or Bloomington office. Travel up to 10%, including overnight travel, is required. In-office requirements may change based on business needs.

Requirements

• Four or more years of relevant experience in healthcare revenue cycle, payer operations, claims processing, healthcare technology, healthcare data integration, or healthcare software implementation.
• Working knowledge of Medicaid and managed care organization revenue cycle and payer processes, including claim submission, payer responses, reimbursement, rejections, and denials.
• Working knowledge of healthcare electronic data interchange and X12 standards, including 837, 835, 270/271, and 276/277 transactions.
• Experience interpreting payer specifications, companion guides, implementation requirements, and data elements; documenting business and technical requirements; and translating them into configuration or integration requirements.
• Experience with configuration-driven software platforms and managing multiple implementation or configuration activities through completion.
• Strong analytical and troubleshooting skills, including the ability to identify root causes, evaluate alternatives, and determine appropriate next steps.
• Knowledge of common healthcare integration methods and technologies, including secure file transfer protocol and application programming interfaces.
• Strong written and verbal communication, organization, and attention to detail; ability to ask effective discovery questions, challenge assumptions constructively, make recommendations, prioritize work, and collaborate across functions.
• Experience with work-management and documentation tools such as Jira, Salesforce, Confluence, or SharePoint, and ability to independently own assigned responsibilities within a cross-functional delivery model.
• Ability to work on-site three days per week in the New York, Miami, or Bloomington office; in-office requirements may change based on business needs.
• Willingness to explore and adopt AI tools responsibly to enhance productivity and innovation in the role.

Nice To Haves

• Experience in home care or home care technology.
• Experience with healthcare software as a service.
• Experience with Health Level Seven or Fast Healthcare Interoperability Resources standards.
• Experience working with state Medicaid agencies, home care providers, or clearinghouses.

Responsibilities

• Gather, analyze, validate, and document customer, payer, business, and technical requirements, translating payer specifications and companion guides into scalable configurations and integration solutions.
• Independently own assigned payer integration and configuration work from requirements definition through testing, validation, and production readiness.
• Configure and maintain payer-specific billing rules, claim submission logic, enrollment requirements, reimbursement workflows, and related system integrations.
• Analyze and troubleshoot implementation and production issues, identify root causes, evaluate alternatives, and recommend and implement appropriate corrective actions within the role’s scope.
• Partner with Implementation, Product, Engineering, Operations, payer, and client-facing teams; support Senior Solution Analysts on complex requirements, escalations, and broader implementation efforts.
• Execute testing, validation, and quality assurance to confirm configurations and integrations meet documented requirements and expected outcomes.
• Support payer onboarding, production-readiness activities, enhancement requests, and ongoing optimization of payer configurations and integrations.
• Monitor and maintain payer configurations and integrations to support performance, accuracy, and compliance with payer requirements.
• Create and maintain requirements, configuration decisions, test results, operating procedures, internal tools, training materials, and best-practice documentation; provide knowledge transfer.
• Bridge technical, operational, payer, and customer requirements while meeting service-level agreements, delivery standards, and internal procedures.
• Perform other duties as assigned by a supervisor or HHAeXchange leader.
• Travel up to 10%, including overnight travel.

Benefits

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed