Contract & Reimbursement Analyst II

Summary

Elevate Patient Financial Solutions provides patient financial and revenue cycle services. The Contract & Reimbursement Analyst II translates managed care agreements into pricing and reimbursement data, analyzes payer methodologies, validates reimbursement models, investigates data discrepancies, and supports pricing strategy, regulatory reporting, and revenue cycle initiatives.

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

Skills

• 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

Qualifications

Must Haves

• 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

• This position will be a remote based role.
• 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