Remote Payer Payment & Reimbursement Analyst

Signature Performance; Phoenix (AZ); 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 is seeking a Payer Payment and Reimbursement Analyst for a remote role available nationwide. You will work with our team to understand reimbursement methodologies, interpret regulatory updates, and translate policy changes into actionable requirements for software design and configuration.

You will analyze complex healthcare data, build Excel models to validate payment methods, and collaborate with Developers, QA, Data, and Client Services to ensure timely delivery of

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, LTCH, FQHC, and physician fee schedule data files.

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.

Skills

Analytical skills

Attention to detail

Policy interpretation

Cross-functional collaboration

Self-directed

Prioritization

Tools

Excel

SQL

TriZetto Facets NetworX

Optum Rate Manager

Job description

Signature Performance is seeking a Payer Payment and Reimbursement Analyst for a remote role available nationwide. You will work with our team to understand reimbursement methodologies, interpret regulatory updates, and translate policy changes into actionable requirements for software design and configuration.

You will analyze complex healthcare data, build Excel models to validate payment methods, and collaborate with Developers, QA, Data, and Client Services to ensure timely delivery of