Contract & Reimbursement Analyst II
Elevate Patient Financial Solutions Contract & Reimbursement Analyst II
Elevate Patient Financial Solutions has an exciting career opportunity available as a Contract & Reimbursement Analyst. This position will be a remote based role. The Full Time schedule for this role will be Monday - Friday- hours will be determined with manager based on Time Zone.
The Contract and Reimbursement Analyst II is a key contributor within the Revenue Cycle Analytics team, responsible for translating complex managed care agreements into actionable pricing and reimbursement data. This role combines healthcare finance, contract analysis, and data analytics to help clients understand payer reimbursement, maintain pricing integrity, and support strategic revenue cycle initiatives.
Essential Duties and Responsibilities
Analyze managed care agreements and reimbursement methodologies to ensure accurate representation within pricing models and analytical tools.
Interpret complex contractual language and resolve ambiguous reimbursement provisions through research and client collaboration.
- Evaluate payer reimbursement structures, stop-loss provisions, and payment methodologies to support pricing accuracy.
- Monitor payer product and plan changes and assess impacts on reimbursement modeling and reporting.
- Validate contract assumptions and reimbursement calculations to ensure consistency and accuracy.
- Support development and maintenance of pricing models used to evaluate payer reimbursement and financial performance.
- Participate in analyses involving room rates, reimbursement methodologies, and payment comparisons.
- Assist in preparation of hospital price transparency files and regulatory reporting requirements.
- Contribute to projects focused on reimbursement optimization, pricing strategy, and operational improvements.
- Investigate discrepancies in pricing and reimbursement data and identify root causes.
- Recommend and implement quality assurance processes that improve data integrity and operational efficiency.
- Compare pricing models and analytical outputs to ensure consistency across clients and reporting periods.
- Communicate findings, risks, and recommendations to leadership and project stakeholders.
- Other duties as assigned.
Qualifications and Requirements
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.
Bachelor’s degree or equivalent experience.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.
Bachelor’s degree or equivalent experience.
- Demonstrated ability to solve complex analytical problems involving large or complex datasets.
- Strong ability to interpret and apply contractual language to financial and operational outcomes.
- Experience identifying and resolving data quality and reporting discrepancies.
- Ability to manage projects and competing priorities with minimal supervision.
- Strong written and verbal communication skills, with the ability to convey findings to both technical and non-technical audiences.
- Demonstrated critical thinking and process improvement skills.
- Ability to collaborate effectively across departments and with external stakeholders.
- Remote and Hybrid positions require home internet connections that meet the company's upload and download speed criteria.
Benefits
ElevatePFS believes in making a positive impact not only within our industry but also with our employees –the organization’s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.
ElevatePFS believes in making a positive impact not only within our industry but also with our employees –the organization’s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.
- Medical, Dental & Vision Insurance
- 401K (100% match for the first 3% & 50% match for the next 2%)
- 15 days of PTO
- 7 paid Holidays
- 2 Floating holidays
- 1 Elevate Day (floating holiday)
- Pet Insurance
- Employee referral bonus program
- Teamwork: We believe in teamwork and having fun together
- Career Growth: Gain great experience to promote to higher roles
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.
The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
ElevatePFS is an Equal Opportunity Employer
The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
ElevatePFS is an Equal Opportunity Employer