HealthRules Payor Configuration Analyst -Remote

RELQ TECHNOLOGIES; United States; Remote; USD 81,000 - 110,000; Full time

Job summary

A leading technology company in healthcare is looking for a HealthRules Payor Configuration Analyst to support the configuration and maintenance of benefit plans. The ideal candidate will have more than 3 years of experience in HealthRules Payor and a solid understanding of healthcare operations, offering opportunities to work in a remote environment.

Qualifications

• 3+ years of experience with HealthRules Payor configuration.
• Understanding of healthcare payer operations.
• Experience with healthcare data standards (e.g., EDI, HIPAA 837/835).

Responsibilities

• Design, build, test, and maintain HealthRules Payor configuration.
• Collaborate with business, IT, and QA teams.
• Document configuration decisions and maintain records.

Skills

Analytical

Problem-solving

Communication

Education

Bachelor's degree or equivalent experience

Job description

HealthRules Payor Configuration Analyst -Remote

HealthRules Payor Configuration Analyst -Remote

3 days ago Be among the first 25 applicants

Job Title: HealthRules Payor Configuration Analyst

Location: Remote – USA

6+ months

Client: Healthcare

8+ yrs needed

Job Summary

We are seeking a detail-oriented and experienced HealthRules Payor Configuration Analyst to support configuration and maintenance of benefit plans, provider contracts, and pricing rules within the HealthRules Payor (HRP) platform. The ideal candidate will have hands-on experience in configuring HRP, a strong understanding of healthcare payer operations, and the ability to collaborate cross-functionally in a remote work environment.

Key Responsibilities

• Design, build, test, and maintain configuration within the HealthRules Payor system for benefit plans, provider contracts, pricing rules, and claims adjudication logic.
• Interpret business requirements and convert them into effective configuration solutions.
• Perform impact analysis of configuration changes and troubleshoot issues related to claims processing and benefits administration.
• Collaborate with business, IT, and QA teams to ensure timely delivery of configuration updates and enhancements.
• Develop and execute configuration test cases; participate in UAT and production validation.
• Ensure compliance with regulatory requirements and support internal/external audits related to configuration.
• Document configuration decisions and maintain up-to-date records for knowledge management and process improvement.
  
  

Required Qualifications

• 3+ years of hands-on experience with HealthRules Payor configuration (benefit plans, pricing, provider contracts, etc.).
• Strong understanding of healthcare payer operations, including claims adjudication, benefits administration, and provider reimbursement.
• Ability to analyze complex business requirements and translate them into technical configuration.
• Experience with healthcare data standards (e.g., EDI, HIPAA 837/835).
• Experience with test planning, execution, and defect resolution.
• Strong analytical, problem-solving, and organizational skills.
• Excellent verbal and written communication skills.
• Ability to work independently in a remote, fast-paced environment.

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Information Technology

• Industries

  IT Services and IT Consulting

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