Payer Integration Solutions Analyst
Core
Implements, maintains, and optimizes home care revenue cycle solutions with a focus on payer integrations and billing configuration.
Role type
Payer Integration Solutions Analyst
Builds
Home care revenue cycle solutions and payer integration configurations
Domain
Healthcare revenue cycle and payer operations
Required skills
Payer integration configuration, X12 standards (837, 835, 270/271, 276/277), Medicaid and managed care processes, claims processing, healthcare data integration, secure file transfer protocol, API integration, Jira, Salesforce, Confluence, SharePoint
Preferred skills
Home care technology, Health Level Seven, Fast Healthcare Interoperability Resources, state Medicaid agency experience, clearinghouse experience
Technologies
X12, 837, 835, 270/271, 276/277, HL7, FHIR, SFTP, APIs, Jira, Salesforce, Confluence, SharePoint
Responsibilities
Translate payer specifications into scalable configurations, configure billing rules and claim submission logic, troubleshoot implementation and production issues, execute testing and validation activities, support payer onboarding and optimization, maintain documentation and knowledge transfer
Seniority
Mid-level, hands-on IC