Provider Data and Contract Analyst

Job Description

Job Description

We are looking for a Provider Data and Contract Analyst to support a long-term contract opportunity within the health insurance industry. In this role, you will examine provider agreements and reimbursement materials, organize critical payment information, and help strengthen the accuracy and accessibility of contract data used across the organization. This position will work closely with operational and business partners to improve data governance and prepare reimbursement documentation for inclusion in an AI-enabled centralized rate repository.

Responsibilities:
• Review provider agreements, reimbursement exhibits, and related records to identify payment terms and methodology details.
• Organize and maintain contract documentation so reimbursement information is structured, traceable, and ready for centralized repository intake.
• Interpret contractual language affecting provider payments, including terms tied to facility and physician reimbursement approaches.
• Partner with business and operational teams to confirm reimbursement details and resolve documentation gaps or inconsistencies.
• Support data quality initiatives by validating the completeness, consistency, and usability of provider payment information.
• Catalog fee schedules and supporting materials in a way that improves transparency and ongoing governance of reimbursement data.
• Contribute to transformation efforts by helping standardize how provider contract information is captured and referenced.
• Assist with analysis related to how reimbursement terms influence claims adjudication and payment accuracy.• Bachelor’s degree in a related field or equivalent practical experience, along with at least 3 additional years of relevant work experience.
• Background in provider contracting, provider network operations, reimbursement analysis, or a closely related healthcare function.
• Working knowledge of reimbursement structures for both facility and provider groups.
• Ability to interpret healthcare contract language, fee schedules, and payment methodologies with a high level of accuracy.
• Understanding of how reimbursement terms affect claims processing, adjudication, and payment outcomes.
• Strong analytical, organizational, and documentation skills with careful attention to detail.
• Familiarity with healthcare claims, payment operations, provider data management, data warehousing, QA, or SQL is preferred.
• Prior experience in a health insurance environment is a plus.