Payor Contracting Analyst

Healthcare Outcomes Performance Company • Phoenix, AZ

4d • Remote

About The Position

This is a remote position focused on payor contracting within the healthcare industry. The role requires an in-depth understanding of physician reimbursement methodologies and the ability to analyze healthcare data. The analyst will be responsible for demonstrating knowledge of CMS regulations, value-based care models, and managed care practices. Strong analytical, problem-solving, and organizational skills are essential for success in this role, along with the ability to work independently and manage multiple projects effectively.

Requirements

• Minimum of three years of experience working in an analytic role in a healthcare environment (payor or provider) with an in-depth knowledge of physician reimbursement methodologies.
• Intermediate to advanced-level MS Excel skills (pivot tables, vlookups, conditional formulas).
• Experience using relational databases.
• Knowledge of physician reimbursement.
• Knowledge of provider billing practices.
• Knowledge of CPT codes, modifier rules, CMS payment policies.
• Skill in effective data collection and analysis.
• High-level attention to detail, accuracy, and organization skills.
• Strong ability to prepare and understand functional and technical specifications.
• Ability to analyze problems and interpret information and prioritize and reprioritize, as necessary.
• Ability to work independently, and as part of a team.
• Ability to multi-task, manage multiple projects, and meet tight deadlines.

Nice To Haves

• Bachelor’s Degree in Finance or Healthcare Administration preferred.
• Familiarity with value-based care payment models and industry trends.
• Familiarity with managed care products and services.
• Familiar with a variety of concepts, practices, and procedures in the field of managed care and practice management.
• Excellent critical thinking, troubleshooting, and analytical skills.

Responsibilities

• Demonstrate thorough knowledge of CMS regulations and reimbursement methodologies relevant to professional claims.
• Analyze physician contracts, utilization, and costs.
• Conduct medical cost trend analysis.
• Design analyses and appropriate reports.
• Stay on task with minimal supervision.
• Manage multiple projects and meet tight deadlines.

Benefits

• Competitive Health & Welfare Benefits
• HSA with qualifying HDHP plans with company match
• 401k plan after 6 months of service with company match (Part-time employees included)
• Employee Assistance Program that is available 24/7 to provide support
• Employee Appreciation Days
• Employee Wellness Events

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level