Reimbursement Technical Analyst
About The Position
As a Reimbursement Technical Analyst Associate, you will make an impact by ensuring accurate and compliant reimbursement processes for healthcare professional services. You will be a valued member of the TPS – NHXS team and collaborate closely with configuration analysts and other operational stakeholders to maintain and improve claims reimbursement systems. In this role, you will: Review health plan-specific reimbursement policies for compliance with contractual and regulatory requirements. Create and maintain table-based rules using health plan disclosures and industry standards (CPT, CCI, CMS). Manage and update the Claims Reimbursement database to ensure edit rules and tables remain current. Partner with operations teams to support organizational growth and process improvements. Communicate ideas effectively and contribute to enhancing business processes. Work model We strive to provide flexibility wherever possible. Based on this role’s business requirements, this is a remote position open to qualified applicants in the United States. Regardless of your working arrangement, we support a healthy work-life balance through various wellbeing programs.
Requirements
- Familiarity with medical/clinical nomenclature.
- Experience with CPT, CCI, CMS, or health plan-specific rules for claim payment.
- Knowledge of health plan/provider contracting and fee schedules.
- Proficiency in Microsoft Excel and Word.
- Strong written and oral communication skills.
- Excellent interpersonal, organizational, and problem-solving abilities.
Nice To Haves
- Bachelor’s degree in a healthcare-related field.
- Experience with dispute resolution and physician billing.
- Certification as a Professional Biller (CPB) or Professional Coder (CPC).
Responsibilities
- Review health plan-specific reimbursement policies for compliance with contractual and regulatory requirements.
- Create and maintain table-based rules using health plan disclosures and industry standards (CPT, CCI, CMS).
- Manage and update the Claims Reimbursement database to ensure edit rules and tables remain current.
- Partner with operations teams to support organizational growth and process improvements.
- Communicate ideas effectively and contribute to enhancing business processes.
Benefits
- Medical/Dental/Vision/Life Insurance
- Paid holidays plus Paid Time Off
- 401(k) plan and contributions
- Long-term/Short-term Disability
- Paid Parental Leave
- Employee Stock Purchase Plan
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Number of Employees
5,001-10,000 employees
