Remote Payer Payment & Reimbursement Analyst

Signature Performance; Omaha (NE); 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–A

401(k) Program with Employer Match

Job summary

Signature Performance is seeking a Payer Payment and Reimbursement Analyst to join our remote team. You will work with professionals to analyze reimbursement methodologies, Medicare‑like policies, and pricing logic for claims adjudication.

The role focuses on improving processes, translating policy updates into business requirements, and developing Excel models to validate payment calculations. Strong analytical thinking and collaboration with Developers, QA, and Client Services are essential.

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, SNF, Home Health, Hospice, ASC).
• Knowledge of Critical Access, Sole Community, Behavioral Health, Inpatient/Outpatient Rehab, Long Term Care Hospital, FQHC, Physician Fee Schedule, DME/DEMPos, Ambulance, AWP, Lab, ESRD, Hospice, Home Health, Anesthesia, ADA.
• 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 reimbursement methodologies.
• Ability to communicate effectively with diverse stakeholders.
• SQL experience preferred.

Responsibilities

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

Skills

Healthcare reimbursement

Regulatory knowledge

Excel modeling

Data analysis

Cross-functional collaboration

Communication skills

SQL reporting

Tools

TriZetto Facets NetworX

Optum Rate Manager

Job description

Signature Performance is seeking a Payer Payment and Reimbursement Analyst to join our remote team. You will work with professionals to analyze reimbursement methodologies, Medicare‑like policies, and pricing logic for claims adjudication.

The role focuses on improving processes, translating policy updates into business requirements, and developing Excel models to validate payment calculations. Strong analytical thinking and collaboration with Developers, QA, and Client Services are essential.