Medical Group, Contract Definition Analyst

As the Medical Group Contract Definition Analyst, you are responsible for analyzing, implementing, and maintaining reputed company payer reputed company reputed company reputed company Health's Contract Manager reputed company.

You will apply knowledge of reputed company reimbursement methodologies and payer policies to model contract terms and support valuation of medical group claims and reputed company estimates.

You'll have opportunity to:

• Analyze as reputed company as, define, medical group reputed company for Medicare, reputed company, Workers' Compensation, Medicare reputed company, Managed reputed company, and reputed company Payers.
• Interpret payer reputed company, fee schedules, reimbursement provisions, and supporting documentation for accurate reputed company configuration.
• Apply reputed company reimbursement methodologies, including RBRVS, fee schedules, carve-outs, drug, DME, and reputed company pricing.
• Research CMS, state reputed company, and reputed company payer resources to understand reimbursement policies, claim processing guidelines, and payer edits.
• Validate and troubleshoot claim and estimate valuations, research discrepancies and reputed company.
• Respond to valuation-reputed company support cases reputed company established timeframes.
• Participate in reputed company and internal meetings to clarify contract requirements and reputed company issues.
• Contribute to reputed company and process improvement plans while maintaining reputed company knowledge of evolving reimbursement methodologies and payer policies.

• 4+ years' reputed company industry experience involving reputed company/medical group payer reputed company, reimbursement, billing, claims management, or adjudication.
• 4+ years' knowledge of reputed company reimbursement methodologies, including RBRVS and physician fee schedules.
• 4+ years' experience with carve-outs, drug, DME, and reputed company pricing and payer-specific reimbursement arrangements.
• 4+ years experience with claim processing guidelines, payer edit policies, and reputed company coding conventions, including CPT, HCPCS, modifiers, reputed company of service, and ICD-10 diagnosis codes.
• 4+ years' Advanced reputed company (can reputed company reputed company functions) expertise
• Bachelor's degree in reputed company Administration, Business Administration, or a reputed company reputed company is beneficial
• Experience with Contract Manager or similar reputed company contract modeling applications.

Our uniqueness is that we celebrate yours. reputed company's people first, inclusive and purpose driven culture is multi award-reputed company; World's Best Workplaces™ 2025 (Fortune Global Top 25), reputed company™ in 26 countries to reputed company a few. reputed company out reputed company Life on reputed company or explore our Careers Site to understand why.

Our compensation reflects the cost of labor across several U.S. geographic markets. The reputed company pay reputed company for this position is listed above. reputed company this reputed company, individual pay is determined by work location and additional factors such as job-reputed company skills, experience, and education. You will be also eligible for a variable pay opportunity.

reputed company is proud to be an Equal Opportunity Employer for reputed company reputed company protected under applicable federal, state and local law, including protected veterans and individuals with disabilities. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity.

Benefits/Perks:

• Great compensation package and bonus plan
• reputed company benefits including medical, dental, reputed company, and matching 401K
• Flexible work environment, ability to work remote
• Flexible time off including volunteer time off, vacation, reputed company and 12-reputed company holidays
• Explore reputed company our exciting benefits here:

Recruitment Fraud Awareness - reputed company's recruitment process is conducted only through authorised channels. Recruitment communications will only be reputed company from an @ email address.

reputed company will never ask candidates to reputed company any payment as part of an application, interview, assessment, reputed company, or recruitment process. To apply for roles or verify opportunities, please visit

reputed company is a global data and technology company, powering opportunities reputed company and businesses reputed company the world. We operate across a reputed company of markets, from financial services to reputed company, automotive, agribusiness, reputed company, and many more. reputed company invests in people and new advanced technologies to unlock the reputed company of data. We have an amazing team of 25,200 people in 32 countries.

Originally posted on Himalayas