Payer Contract Analyst: Reimbursement & Analytics

Summit Orthopedics; Woodbury (MN); On-site; USD 68,000 - 85,000; Full time

Job summary

Summit Orthopedics provides comprehensive orthopedic care across the Twin Cities, Greater Minnesota and Western Wisconsin. The Payer Contract Analyst will interpret reimbursement terms, model financial impact and support negotiations within Revenue Cycle, Operations and Finance.

The role administers Strata analytics, builds models and ensures contractual compliance. Preferred candidates have a Bachelor's degree and at least 3 years in healthcare finance, with strong Excel and PowerBI skills to

Qualifications

• Minimum 3 years of experience in revenue cycle, managed care, healthcare finance or related field.
• Strong analysis skills and proficiency with Excel and PowerBI.
• Payer contracting or understanding of payer reimbursement methodologies preferred.

Responsibilities

• Serves as System Administrator of Strata Decision Technology's Contract Analytics platform
• Builds and maintains reimbursement models for payer contracts
• Translates contract language into expected reimbursement logic
• Analyzes payer proposals or policy changes and models financial impact
• Supports payer rate negotiations, contract renewals and underpayment audit process
• Validates expected reimbursement calculations against actual payments and monitors for compliance or issue escalation
• Assesses Price Transparency data and assists with ensuring Summit is compliant with regulations
• Prepares contract performance reports and payer scorecards
• Performs Ambulatory Surgery Center (ASC) case costing, profitability analysis and special requests, providing recommendations for place of service
• Prepares ad hoc reports and analysis, and performs other duties, as assigned

Skills

Analytical skills

Education

Bachelor's degree (preferred)

Tools

Microsoft Excel

Microsoft PowerBI

Job description

Summit Orthopedics provides comprehensive orthopedic care across the Twin Cities, Greater Minnesota and Western Wisconsin. The Payer Contract Analyst will interpret reimbursement terms, model financial impact and support negotiations within Revenue Cycle, Operations and Finance.

The role administers Strata analytics, builds models and ensures contractual compliance. Preferred candidates have a Bachelor's degree and at least 3 years in healthcare finance, with strong Excel and PowerBI skills to