Reimbursement Technical Analyst

A company is looking for a Reimbursement Technical Analyst.

Key Responsibilities

Review health plan-specific reimbursement policies for compliance with contractual and regulatory requirements

Create and maintain table-based rules using health plan disclosures and industry standards

Manage and update the Claims Reimbursement database to ensure edit rules and tables remain current

Required Qualifications

Familiarity with medical / clinical nomenclature

Experience with CPT, CCI, CMS, or health plan-specific rules for claim payment

Knowledge of health plan / provider contracting and fee schedules

Proficiency in Microsoft Excel and Word

Bachelor's degree in a healthcare-related field (preferred)