Hospital Contract Definition Analyst, Healthcare

Experian

. Play a critical role in the implementation and maintenance of hospital payer contracts within Experian Health's Contract Manager system .

Posted 5/20/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $57,111 - $98,993 per yearWebsite

About the role

Key responsibilities & impact

Play a critical role in the implementation and maintenance of hospital payer contracts within Experian Health's Contract Manager system
Ensure accurate modeling of reimbursement methodologies to support valuation of hospital claims and patient estimates
Collaborate with senior team members to process new client implementations and independently manage routine maintenance cases
Ensure compliance with enterprise standards and client expectations
Validate and troubleshoot system-generated valuations against client-submitted claims and estimates, reconciling discrepancies due to data entry errors or policy interpretation
Participate in internal and client meetings to support project agreement and issue resolution
Contribute to process improvement aimed at reducing manual effort and enhancing data accuracy

Requirements

What you’ll need

3+ years experience in the hospital industry, with direct involvement in payer contracts, facility reimbursement methodologies, and adjudication rules
2+ years direct experience with hospital billing, claims management (facilities, appeals), and payer contracting
2+ years in-depth knowledge of facility reimbursement models used by commercial payers, Medicare, and Medicaid for both inpatient and outpatient services
2+ years proficiency in coding systems including CPT, HCPCS, DRG, Revenue Codes, Occurrence Codes, ICD-10 Diagnosis and Procedure Codes
Learn new and changing reimbursement methodologies and underlying logic
Bachelor's degree in Healthcare Administration, Finance, Accounting, or Business Administration or equivalent experience

Benefits

Comp & perks

Great compensation package and bonus plan
Core benefits including medical, dental, vision, and matching 401K, and life and disability insurance
Family leave
Flexible work environment, ability to work remote, hybrid or in-office
Flexible time off including volunteer time off, vacation, sick and 12-paid holidays

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

hospital billingclaims managementpayer contractingfacility reimbursement methodologiesCPT codingHCPCS codingDRG codingRevenue CodesOccurrence CodesICD-10 coding

Soft Skills

collaborationproblem-solvingcommunicationprocess improvementattention to detail