Remote Healthcare Payer Payment & Reimbursement Analyst

Signature Performance; Boston (MA); Remote; USD 84,150 - 113,850; Full time

Benefits offered by this job

Health Insurance

Fully Paid Life Insurance

Fully Paid Short- & Long-Term Disabi­l

Paid Vacation

Paid Sick Leave

Paid Holidays

Professional Development and Tuition

401(k) Program with Employer Match

Job summary

Signature Performance seeks a Payer Payment and Reimbursement Analyst to join a remote, nationwide team. You will work under the Project Manager to interpret Medicare and other payer policies, translate updates into actionable business requirements, and support system configuration and testing.

The role focuses on analyzing reimbursement methodologies, maintaining pricing logic, and collaborating with Developers, QA, Data, and Client Services to ensure accurate adjudication and timely delivery.

Qualifications

• 3-4 years of professional experience in healthcare provider payment and reimbursement.
• Knowledge of healthcare billing, compliance, and payer reimbursement regulations.
• Experience with professional and institutional payment fee schedules and PPS (DRG, OPPS, Skilled Nursing, Home Health, Hospice, ASC).
• Familiarity with Medicare/VA/CHAMPVA/TRICARE policies and fee schedules.
• Ability to translate complex reimbursement policies into clear business requirements.

Responsibilities

• Configure and maintain payment, pricing, and contract logic in reimbursement systems.
• Analyze regulatory updates and system changes for impact on processes and data systems.
• Review large healthcare data sets to identify trends and required changes.
• Collaborate with government agencies to clarify reimbursement policies.
• Develop Excel models to validate payment methodologies.
• Create and execute test claims for development, UAT, QA, and configuration validation.

Skills

Healthcare reimbursement

Analytical thinking

Problem solving

Team collaboration

Stakeholder communication

Attention to detail

Tools

TriZetto Facets NetworX

Optum Rate Manager

Excel modeling

Job description

Signature Performance seeks a Payer Payment and Reimbursement Analyst to join a remote, nationwide team. You will work under the Project Manager to interpret Medicare and other payer policies, translate updates into actionable business requirements, and support system configuration and testing.

The role focuses on analyzing reimbursement methodologies, maintaining pricing logic, and collaborating with Developers, QA, Data, and Client Services to ensure accurate adjudication and timely delivery.