Remote Healthcare Ops Analyst - Claims & Policy Analytics

Ultimate Staffing; Roseville (MN); Remote; USD 67,000 - 75,000; Full time

Job summary

Ultimate Staffing is seeking a Healthcare Operations Analyst to support healthcare operations, payer policy analysis, claims investigations, contract administration, and compliance initiatives in a fully remote role. This role requires 3+ years in healthcare operations, Salesforce experience, and strong root-cause analysis, along with excellent communication to coordinate with cross-functional teams.

You will review payer policies, assist audits and appeals, maintain documentation, and drive

Qualifications

• 3+ years in healthcare operations or related fields.
• Experience with healthcare claims, payer policies, or audits.
• Strong root cause analysis and investigative skills.
• Salesforce experience required.
• Excellent communication and relationship-building skills.
• Attention to detail and organizational skills.
• Ability to learn quickly in a fast-paced environment.
• Experience with Medicare/Medicaid and commercial plans.
• Knowledge of provider contracting, credentialing, reaccreditation, or payer enrollment.
• Advanced reporting and data analysis skills.

Responsibilities

• Analyze healthcare claims, reimbursement issues, and payer policy discrepancies.
• Conduct root cause analysis to resolve operational and payment issues.
• Support contract administration, compliance activities, and initiatives.
• Research and resolve escalated payer and claims concerns.
• Review payer policies, reimbursement guidelines, and documentation requirements.
• Assist with audits, appeals, and compliance-related activities.
• Utilize Salesforce to track cases, workflows, escalations, and reporting.
• Collaborate with internal teams to improve processes and efficiencies.
• Maintain accurate records, documentation, and reporting.

Skills

Root cause analysis

Communication

Attention to detail

Organizational skills

Problem solving

Data analysis

Remote work

Multi-tasking

Tools

Salesforce

Job description

Ultimate Staffing is seeking a Healthcare Operations Analyst to support healthcare operations, payer policy analysis, claims investigations, contract administration, and compliance initiatives in a fully remote role. This role requires 3+ years in healthcare operations, Salesforce experience, and strong root-cause analysis, along with excellent communication to coordinate with cross-functional teams.

You will review payer policies, assist audits and appeals, maintain documentation, and drive