Remote Healthcare Reimbursement & Payment Analyst

Signature Performance; Denver (CO); Remote; USD 89,100 - 108,900; Full time

Benefits offered by this job

Health Insurance

Fully Paid Life Insurance

Fully Paid Short-Term Disability

Fully Paid Long-Term Disability

Paid Vacation

Paid Sick Leave

Paid Holidays

Tuition Assistance

401(k) Program with Employer Match

Job summary

Signature Performance is seeking a Payer Payment and Reimbursement Analyst for a fully remote, nationwide role. You will analyze reimbursement methodologies, interpret policy with Medicare, VA, and TRICARE, and translate updates into actionable business requirements.

You will collaborate with cross-functional teams to ensure accurate claims adjudication, maintain pricing logic, and develop Excel models to validate methodologies.

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, Inpatient/Outpatient Rehab, Long Term Care Hospital, and related payer data.

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 and data systems.
• Review and evaluate large healthcare data sets to identify trends, anomalies, and required system changes.
• Interpret Medicare, VA, CHAMPVA, and TRICARE policies, including rulings and fee schedules.
• Translate policy updates into clear business requirements for software design and system configuration.
• Develop complex Excel models to validate payment methodologies.
• Partner with Developers, QA, Data, and Client Services to implement requirements on schedule.

Skills

Payment methodologies

Reimbursement analysis

Regulatory compliance

Analytical thinking

SQL reporting

Tools

TriZetto Facets NetworX

Optum Rate Manager

Excel

Job description

Signature Performance is seeking a Payer Payment and Reimbursement Analyst for a fully remote, nationwide role. You will analyze reimbursement methodologies, interpret policy with Medicare, VA, and TRICARE, and translate updates into actionable business requirements.

You will collaborate with cross-functional teams to ensure accurate claims adjudication, maintain pricing logic, and develop Excel models to validate methodologies.