Contract Analyst I

About the role

This position requires an incumbent to analyze healthcare reimbursement contracts and load contract terms between payers and providers in an accurate and timely manner using proprietary software. This position reports to the Manager of Contract Configuration and will collaborate with the programming and development teams in the creation and vetting of calculation methods, database loads, or changes. This position is an internal resource to staff and clients and as such is expected to respond to client issues and cases in a timely manner.

Responsibilities

• Set up basic contract loads: simple single case agreements (SCAs), basic % of billed charges (BCs), basic % of Medicare, general carve-out codes and basic fee schedule set up.
• Interpret complex contract terms, analyze reimbursement methodologies, and rate structures (e.g., DRG, APC, CPT/HCPCS, ICD-10).
• Load, maintain, and audit client contracts within the adjudication system.
• Validate and test contract configurations for claims pricing accuracy.
• Maintain fee schedule in contract databases and apply annual escalators for client auto renewals.
• Link contracts to payer products, update and maintain provider groups within client databases to ensure seamless claims routing.
• Handles confidential material on a regular basis and is responsible for protecting the confidentiality of such information within the established guidelines of Company and law. (HIPAA Compliance)

Requirements

• Bachelor’s Degree or equivalent work experience in Healthcare Revenue Cycle Management/Contracting field
• Microsoft product proficiency. Must be an intermediate to expert user of Excel
• Possess solid analytical and math skills; self-motivated and detail oriented

Qualifications

• Must be able to handle confidential material on a regular basis and protect the confidentiality of such information within the established guidelines of Company and law. (HIPAA Compliance)

Skills

• Intermediate to expert user of Excel
• Solid analytical and math skills
• Self-motivated and detail oriented

Benefits

Zelis offers a highly competitive benefits package including a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage.

Pay

$54,000.00 - $68,400.00

Schedule

Our hybrid approach is flexible, and in-office presence is guided by team and business needs rather than a fixed weekly schedule.