Remote Healthcare Payer Analytics & Reimbursement Expert

Signature Performance; Albuquerque (NM); Remote; USD 84,150 - 113,850; Full time

Benefits offered by this job

Health Insurance

Fully Paid Life Insurance

Fully Paid Short- & Long-Term Discount

Paid Vacation

Paid Sick Leave

Paid Holidays

Professional Development and Tuition

401(k) Program with Employer Match

Job summary

Signature Performance is seeking a Payer Payment and Reimbursement Analyst for a remote-based role, working with healthcare payment and reimbursement methodologies under mentorship. You will manage multiple projects, analyze regulatory updates, and translate policy changes into actionable business requirements for software config.

Responsibilities include configuring reimbursement systems, analyzing data for trends, collaborating with government agencies, and developing Excel models to validate

Qualifications

• Strong analytical and critical-thinking skills.
• High attention to detail and quality.
• Ability to synthesize complex policy and data into practical solutions.

Responsibilities

• Configure and maintain payment, pricing, and contract logic to ensure accurate claims adjudication.
• Analyze vendor bulletins, regulatory updates, and system changes to assess impact on processes, products, and data systems.
• Review large healthcare data sets to identify trends, anomalies, and required changes.
• Interpret Medicare, VA, CHAMPVA, and TRICARE policies and data files.
• Collaborate with government agencies to clarify new or existing reimbursement policies.
• Translate policy updates into clear business requirements for software design and system configuration.
• Develop complex Excel models to validate payment methodologies.
• Identify claim data characteristics for testing pricing logic.
• Partner with Developers, QA, Data, and Client Services to ensure requirements are implemented on schedule.
• Create and execute test claims for development, UAT, QA, and configuration validation.
• Perform configuration testing and troubleshoot pricing or payment discrepancies.
• Maintain knowledge of company products, data, and services including contracting and reimbursement features.
• Independently resolve complex pricing and reimbursement issues while juggling priorities.

Skills

Analytical thinking

Attention to detail

Policy/data synthesis

Communication & collaboration

Self-motivation

Tools

SQL reporting

TriZetto Facets NetworX

Optum Rate Manager

Excel

Microsoft Office

Job description

Signature Performance is seeking a Payer Payment and Reimbursement Analyst for a remote-based role, working with healthcare payment and reimbursement methodologies under mentorship. You will manage multiple projects, analyze regulatory updates, and translate policy changes into actionable business requirements for software config.

Responsibilities include configuring reimbursement systems, analyzing data for trends, collaborating with government agencies, and developing Excel models to validate