Remote Hospital Contract Analyst - Reimbursement & Compliance

Experian; United States; Hybrid; USD 66,000 - 114,000; Full time

Benefits offered by this job

Bonus plan

Medical/dental/vision coverage

Flexible work setup (remote/hybrid/in‑

Paid time off

Benefits portal

Job summary

Experian Health is seeking a Hospital Contract Definition Analyst to support the implementation and maintenance of hospital payer contracts within Contract Manager. You will model reimbursement methodologies to support valuation of claims and patient estimates while driving efficiency on client projects.

The ideal candidate has 3+ years in hospital payer contracts, 2+ years in hospital billing and claims management, and fluency with CPT, HCPCS, DRG, Revenue Codes and ICD-10 coding.

Qualifications

• 3+ years in hospital industry with payer contracts and adjudication rules.
• 2+ years in hospital billing, claims management, and payer contracting.
• 2+ years knowledge of facility reimbursement models for inpatient/outpatient.
• 2+ years proficiency in CPT, HCPCS, DRG, Revenue Codes, ICD-10.

Responsibilities

• Analyze and maintain hospital payer contracts using Contract Manager.
• Validate system valuations against client claims and reconcile discrepancies.
• Research payer rules and reimbursement policies to stay current.
• Ensure contract terms reflect client intent and payer agreements.
• Participate in internal and client meetings to support projects and issue resolution.
• Identify process improvements to reduce manual effort and improve accuracy.

Skills

Payer contracts

Adjudication rules

Hospital billing

Claims management

Payer contracting

Facility reimbursement models

Coding knowledge

Education

Bachelor's degree in Healthcare Administration or related field

Job description

Experian Health is seeking a Hospital Contract Definition Analyst to support the implementation and maintenance of hospital payer contracts within Contract Manager. You will model reimbursement methodologies to support valuation of claims and patient estimates while driving efficiency on client projects.

The ideal candidate has 3+ years in hospital payer contracts, 2+ years in hospital billing and claims management, and fluency with CPT, HCPCS, DRG, Revenue Codes and ICD-10 coding.