Payor Analyst - Reimbursement HUB Services

United Biosource Corporation•All Virtual Locations, Home Based Position, USA, Remote, US,

8d•Remote

About The Position

The Payor Analyst supports reimbursement HUB services by maintaining critical payer and reference system files, collecting and validating payer insights, and helping ensure that staff and clients have current information on payer policies and processes. The role maintains the Payer Information Management System database, including referring healthcare professional files and insurance database content such as payer processing information, prior authorization and appeal requirements, contacts, forms, and payer best practices. The analyst works across hub, field reimbursement, market access, analytics, operations, quality, and client teams to identify and communicate changes in payer policies, requirements, and review processes. The role also supports audit and deep-dive requests by gathering documentation, prepares progress presentations for client meetings, helps develop payer roadmaps, and educates staff and clients on reimbursement procedures and best practices. The position is remote and has a Monday–Friday schedule from 8:00 a.m. to 4:30 p.m. Eastern Time. UBC describes its workplace culture as inclusive and grounded in collaboration, conscientiousness, curiosity, consultation, and compassion.

Requirements

At least 5 years of professional work experience.
At least 3 years of Microsoft Office experience.
High school diploma or GED.
Strong written and verbal communication skills, including the ability to interact with internal and external business partners in person or by phone.
Ability to work effectively with internal and external functional departments.
Ability to organize assignments, set priorities, and complete work with minimal supervision.
Ability to manage multiple tasks and prioritize effectively.
Accuracy and attention to detail, organization, follow-up, effective communication, and ownership of work.
Proficiency in Excel, Access, Word, and PowerPoint.

Nice To Haves

Payer experience, particularly in healthcare reimbursement, pharmacy benefit management, or a hospital setting.
Healthcare or reimbursement background with 1–3 years of auditing and quality assurance experience.
Knowledge of insurance plans, including Medicaid, Medicare, and TRICARE.
Knowledge of insurance benefits, including prior authorization and appeals processes.
Medical terminology experience and 1–3 years of related industry experience or training, or an equivalent combination of education and experience.
Demonstrated leadership capabilities.

Responsibilities

Maintain and clean the Payer Information Management System database and related files, including referring healthcare professional files and insurance database information.
Collect and validate payer-policy and process insights from cross-functional teams.
Liaise with internal functions to understand and share changes in payer policies, requirements, and processes.
Receive payer notices and updates, add relevant information to the payer database, inform staff of changes, and maintain a record of payer notices.
Work with operations groups to create payer roadmaps guiding users to appropriate billing, prior authorization, appeal documentation, and procedures based on prescribed treatment.
Assist the Quality team with gathering documentation for audits and deep-dive requests, and prepare and present progress updates to clients during business reviews.
Educate staff on departmental policies and procedures, including ways to maximize first-submission success.
Serve as an operations subject-matter expert and educate clients on best practices.
Partner with client stakeholders to exchange information about payer trends and changes.
Participate in payer focus groups and other meetings to identify and share payer nuances and trends.
Provide insights and key learnings to internal and client stakeholders as needed.
Work with leadership to communicate updates to hub stakeholders and with Quality to ensure learnings are incorporated into practice.