Contract Analyst

Job Description

Job Description

JOB SUMMARY

The Contract Analyst provides analytical and technical support for payer contracting, reimbursement analysis, fee schedule management, and revenue cycle initiatives. This position is responsible for analyzing payer reimbursement methodologies and contract performance, maintaining and validating fee schedules, identifying reimbursement variances, and developing financial models to support contract negotiations, renewals, and business decision-making.

The Contract Analyst also leverages SQL, Power BI, and other analytical tools to evaluate financial and operational performance, identify trends and opportunities, improve reporting, and support revenue cycle optimization.

KEY RESPONSIBILITIES

• Manage, maintain, validate, and analyze payer fee schedules within the Practice Management System to support accurate reimbursement.
• Analyze payer contract terms, reimbursement methodologies, payment rules, and fee schedules to evaluate reimbursement performance and support revenue cycle operations.
• Use SQL and ad hoc reporting tools to query, extract, analyze, and interpret revenue cycle, billing, and reimbursement data.
• Conduct reimbursement variance analysis using Rivet and other analytical and reporting tools to identify underpayments, payment discrepancies, short-pays, and systemic reimbursement issues.
• Partner with Revenue Cycle and other operational teams to translate reimbursement variance findings into actionable recovery opportunities, process improvements, and workflow enhancements.
• Develop financial models, reimbursement projections, and scenario analyses to evaluate the potential financial impact of proposed contract terms, reimbursement changes, payer negotiations, and renewals.
• Provide analytical support, executive summaries, and recommendations to leadership involved in payer contract negotiations and strategic decision-making.
• Evaluate financial and operational data to develop business analyses, projections, trends, and recommendations that support leadership decision-making.
• Query and analyze raw billing and reimbursement data using SQL and develop interactive dashboards, reports, and data visualizations within Power BI.
• Monitor reimbursement trends and contract performance to identify opportunities to improve reimbursement accuracy, revenue realization, and financial performance.
• Participate in and lead special projects involving research, auditing, tracking, reporting, process improvement, and documentation related to reimbursement and Revenue Cycle functions.
• Prepare ad hoc reports, analyses, and presentations for executive, management, and departmental leadership as requested.
• Identify opportunities to improve data integrity, reporting processes, analytical methodologies, reimbursement accuracy, and operational efficiency.
• Maintain appropriate documentation of reimbursement methodologies, fee schedules, analytical processes, and reporting standards.
• Perform other duties as assigned.

EDUCATION AND EXPERIENCE

• Bachelor’s degree in Finance, Accounting, Business Analytics, Healthcare Administration, Information Systems, or a related field required. An equivalent combination of education and relevant experience may be considered.
• Minimum of two years of experience in healthcare analytics, revenue cycle, payer reimbursement, financial analysis, business analytics, or a related field.
• Experience working with healthcare billing, payer reimbursement, contract terms, or revenue cycle data preferred.
• Experience working with large financial, operational, or healthcare data sets preferred.

REQUIRED QUALIFICATIONS & SKILLS

• Strong analytical, critical-thinking, problem-solving, and decision-making skills.
• Ability to interpret complex financial and operational data, identify trends and variances, and effectively communicate findings and recommendations.
• Working knowledge of SQL with the ability to query, extract, manipulate, and analyze large data sets.
• Advanced Microsoft Excel skills, including experience working with formulas, lookups, pivot tables, data analysis, and large data sets.
• Strong organizational skills with the ability to manage multiple priorities, meet deadlines, and work independently.
• Excellent written and verbal communication skills with the ability to communicate analytical findings to both technical and non-technical audiences.
• Strong attention to detail and commitment to data accuracy and integrity.
• Ability to learn new technologies, systems, processes, and analytical tools quickly.
• Proficiency with Microsoft Word and Outlook.

PREFERRED QUALIFICATIONS & SKILLS

• Experience developing dashboards, reports, and data visualizations using Microsoft Power BI.
• Experience with Rivet or similar healthcare reimbursement analytics platforms.
• Knowledge of healthcare billing, coding, payer reimbursement methodologies, and revenue cycle operations.
• Experience with payer contracts, reimbursement modeling, or fee schedule analysis.
• Experience working within a healthcare Practice Management System.

ORTHOPAEDIC SOLUTIONS MANAGEMENT IS A DRUG FREE WORKPLACE

We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug-free workplace. All candidates will be required to undergo pre-employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy.

Equal Employment Opportunity & Work Force Diversity

Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.