RCM Business Enablement Analyst

📋 Description

• Build, test, maintain, and optimize insurance payer contracts and expected reimbursement rules to
• Apply healthcare, technical, analytical, and financial knowledge to ensure payer contracts are
• Coordinate with Operations to validate and maintain reimbursement rules following initial
• Maintain reimbursement model updates, including Medicare outpatient quarterly updates, annual DRG
• Perform comprehensive QA and testing by reviewing reports, outputs, and model results before
• Partner with clients, managers, and team leads to research and resolve managed care contract

🎯 Requirements

• 1–3 years of relevant professional experience preferred, with 5+ years of healthcare industry
• Background in healthcare revenue cycle management, billing, coding, or related areas strongly
• Working knowledge of managed care contracting and reimbursement modeling is desirable.
• Understanding of CMS reimbursement guidelines, including Medicare, IPPS, and OPPS logic.
• Strong analytical thinking and the ability to evaluate data, workflows, and systems to identify
• Strong verbal and written communication skills, including the ability to explain complex

🎁 Benefits

• Fully remote position within the United States, aligned with Central Time.
• Full-time employment.
• No travel required; travel expectation is 0%.
• Opportunity to work at the intersection of healthcare, revenue cycle management, technology
• Collaborative environment with opportunities to work alongside healthcare operations and
• Exposure to payer contracting, reimbursement modeling, Medicare methodologies, and Revenue