Network Contract Analyst

Capital Blue Cross

Network Contract Analyst performing contract administration duties for Capital Blue Cross. Handling contract settlements and provider reimbursement to ensure compliance and accuracy.

Posted 7/6/2026full-timeRemote • Pennsylvania • 🇺🇸 United StatesJuniorMid-Level💰 $63,350 - $119,390 per yearWebsite

Tech Stack

Tools & technologies

Tableau

About the role

Key responsibilities & impact

Perform contract administration activities including the preparation of contract settlements
Ensure claims are paid in accordance with contract provisions and plan payment levels
Perform research, analytic, and reporting work in support of Provider Contracting and Value Based Programs
Work with team manager and other analysts to develop and administer contracts with healthcare providers
Prepare provider contract settlements ensuring accuracy and compliance with payment provisions
Manage Cost Rate Adjustment (CRA) process
Respond to inquiries and resolve reimbursement issues from providers
Develop proactive analytical studies on provider billing patterns

Requirements

What you’ll need

2-3 years’ experience in a health care environment with proven analytical expertise is desired
Proven understanding of Capital BlueCross provider contract provisions
Knowledge of general accounting practices and auditing procedures/techniques
Familiarity with Medicare and Medicaid reimbursement methodologies (facility and professional providers)
Demonstrated knowledge of and development experience with various tools such as Microsoft Office Suite products (Access, Excel, Word, etc.), Crystal Reports, Tableau, and SAS
Ability to perform at an intermediate skill level in Access including query development, table joins and formulas
Ability to perform at an intermediate level in Excel utilizing formulas, pivot tables and other functions/formulas

Benefits

Comp & perks

Medical, Dental & Vision coverage
Retirement Plan
Generous time off including Paid Time Off, Holidays, and Volunteer time off
Incentive Plan
Tuition Reimbursement
Flexible environment for health and well-being

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Contract SettlementsClaims ProcessingCost Rate Adjustment (CRA)Analytic ReportingQuery DevelopmentTable JoinsFormulas

Soft Skills

Problem SolvingCommunication