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Payer Contract and Reimbursement Analyst
EtchPayer Contract and Reimbursement Analyst managing payer strategies and operational issue resolution at Dolly Parton Children’s Hospital. Requires strong analytical and communication skills in healthcare operations.
About the role
Key responsibilities & impact- Support negotiation of payer agreements across various service lines by providing analysis, modeling, and contract interpretation.
- Interpret payer contract terms, payment methodologies, and reimbursement logic, translating contract language into clear operational and analytical workflows.
- Build, configure, test, and maintain payer contract structures within Epic Contract Management or related systems, ensuring accurate reimbursement calculations.
- Maintain annual contract escalators and fee schedules; timely updates must be shared with internal partners.
- Perform contract modeling, reimbursement analysis, and payment variance reviews.
Requirements
What you’ll need- Bachelor’s degree in business, finance, healthcare administration, or a related field preferred.
- Three years of healthcare, managed care, payer contracting, revenue cycle, healthcare analytics, or related experience required.
- Epic Resolute Hospital Billing and/or Professional Billing certification expected.
- Strong knowledge of managed care contracting, payer reimbursement methodologies, and payer-provider operations.
- Working knowledge of hospital, professional, and ancillary fee schedules and reimbursement terminology, including CPT, HCPCS, DRG, APC, revenue codes, and claim denial workflows.
- Strong analytical, critical thinking, and problem-solving skills.
- Excellent written, verbal, and interpersonal communication skills.
- Strong attention to detail, sound judgment, and timely responsiveness in a fast-paced environment.
Benefits
Comp & perks- Health insurance
- Paid time off
- Flexible work arrangements
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
contract modelingreimbursement analysispayment variance reviewspayer contract structuresreimbursement calculationsfee schedulesCPTHCPCSDRGAPC
Soft Skills
analytical skillscritical thinkingproblem-solving skillswritten communicationverbal communicationinterpersonal communicationattention to detailsound judgmenttimely responsiveness
Certifications
Epic Resolute Hospital Billing certificationProfessional Billing certification