Hospital Contract Definition Analyst, Healthcare (Remote) at Expedia

New Orleans, Louisiana, United States

Apply Now

Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

3+ years' experience in the hospital industry, with direct involvement in payer contracts, facility reimbursement methodologies, and adjudication rules
2+ years' direct experience with hospital billing, claims management (facilities, appeals), and payer contracting
2+ years' in-depth knowledge of facility reimbursement models used by commercial payers, Medicare, and Medicaid for both inpatient and outpatient services
2+ years' proficiency in coding systems including CPT, HCPCS, DRG, Revenue Codes, Occurrence Codes, ICD-10 Diagnosis and Procedure Codes
Bachelor's degree in Healthcare Administration, Finance, Accounting, or Business Administration preferred

Responsibilities

Implement and maintain hospital payer contracts within Experian Health's Contract Manager system
Ensure accurate modeling of reimbursement methodologies to support valuation of hospital claims and patient estimates
Analyze and interpret complex contract provisions and reimbursement rates submitted by clients to identify all necessary terms for accurate system configuration
Research payer websites and regulatory sources (CMS, state Medicaid, commercial payers) to stay current on adjudication rules and reimbursement policies
Validate (and troubleshoot) system-generated valuations against client-submitted claims and estimates, reconciling discrepancies due to data entry errors or policy interpretation
Ensure contract terms are accurate and implemented according to client intent and payer agreements
Respond to valuation-related support cases within defined Service Level Agreement timeframes
Participate in internal and client meetings to support project agreement and issue resolution
Contribute to process improvement initiatives aimed at reducing manual effort and enhancing data accuracy

Skills

Expedia

Travel booking platform for flights, hotels, rentals

About Expedia

Expedia Group operates in the travel industry, offering a wide range of services for travelers and travel-related businesses. It connects users with options for flights, hotels, car rentals, vacation packages, and activities through its various brands, including Expedia, Hotels.com, and Vrbo. Travelers can easily find and book trips that match their preferences and budgets. The company earns revenue primarily through commissions on bookings and advertising from travel service providers looking to promote their offerings. Additionally, Expedia Group supports its partners by providing access to valuable data and technology, helping them improve their operations and grow their businesses. The goal of Expedia Group is to create a seamless travel experience for users while maximizing the potential of its partners.

Bellevue, WashingtonHeadquarters

1996Year Founded

$3,277.3MTotal Funding

IPOCompany Stage

Consumer Goods, EntertainmentIndustries

10,001+Employees

Benefits

Competitive Paid Time Off

Travel Discounts

Healthcare Flexible Spending Accounts

Employee Assistance Program

Wellness & Travel Reimbursement

Workplace Accomodations

Medical, Dental, & Vision Insurance

Matching Gifts

New Parental Benefits

Risks

Riyadh Air's entry could increase competition, affecting Expedia's market share.

CFO transition may lead to strategic shifts impacting financial management and investor confidence.

Expedia's partnerships may strain resources, affecting service quality if not managed well.

Differentiation

Expedia offers a comprehensive suite of travel services under one platform.

The company leverages a diverse portfolio of brands like Hotels.com and Vrbo.

Expedia provides partners with valuable data and technology to optimize their offerings.

Upsides

Expedia can capitalize on the rise of 'workcations' with longer stay packages.

The trend of 'bleisure' travel offers opportunities for specialized leisure-business packages.

Increased demand for personalized travel experiences can enhance user engagement for Expedia.

Land your dream remote job 3x faster with AI

Try Jobo Free