Remote Healthcare Payer & Reimbursement Analyst

Signature Performance; Memphis (TN); Remote; USD 89,100 - 108,900; Full time

Benefits offered by this job

Health Insurance

Life Insurance

Disability Insurance

Paid Vacation

Paid Sick Leave

Paid Holidays

Tuition Assistance

401(k) Match

Job summary

Signature Performance is seeking a Payer Payment and Reimbursement Analyst to work remotely from anywhere in the United States. You will configure and monitor reimbursement systems, analyze regulatory changes, and translate policy updates into actionable business requirements.

The role demands strong problem-solving, data interpretation, and collaboration with developers, QA, and client services teams. You will review complex data sets, develop Excel models, and interact with government agencies

Qualifications

• 3–4 years of professional experience in healthcare provider payment and reimbursement.
• Working knowledge of healthcare billing, compliance, and payer reimbursement regulations.
• Experience with professional and institutional payment fee schedules, including PPS (DRG, OPPS, Skilled Nursing, Home Health, Hospice, ASC).
• Knowledge of Critical Access, Sole Community, Behavioral Health, and related reimbursement themes.
• Ability to collect, research, interpret, and document complex information into clear business requirements.
• Strong interpersonal and cross-functional collaboration skills.
• Working knowledge of provider types, specialties, and their applicable reimbursement methodologies.
• Ability to communicate effectively with diverse internal and external stakeholders.
• SQL reporting experience preferred.

Responsibilities

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

Skills

Analytical skills

Critical thinking

Attention to detail

Policy/data interpretation

Collaboration

Self-direction

Prioritization

Tools

TriZetto Facets NetworX

Optum Rate Manager

Excel

Job description

Signature Performance is seeking a Payer Payment and Reimbursement Analyst to work remotely from anywhere in the United States. You will configure and monitor reimbursement systems, analyze regulatory changes, and translate policy updates into actionable business requirements.

The role demands strong problem-solving, data interpretation, and collaboration with developers, QA, and client services teams. You will review complex data sets, develop Excel models, and interact with government agencies