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Provider Contract Claims Analyst

Innovative Healthware Services, Inc. DBA ClaimsBridge

ClaimsBridge is a healthcare claims processing SaaS company based in Arnold, Maryland. The company is seeking an experienced healthcare contract analyst to review, configure, and maintain provider contracts in its proprietary claims adjudication platform.

The role focuses on interpreting medical, hospital, and ancillary facility contracts, applying correct pricing methodologies, managing claims queues, and ensuring accurate claim pricing and configuration. The position also involves collaborating with provider network clients and third-party administrators, creating test scenarios, documenting contract changes, and contributing to product improvements.

This role is preferred onsite in Arnold, MD, but remote work may be considered for the ideal candidate.

Requirements & Qualifications

Qualifications

  • 5+ years of experience in healthcare claims and contract work
  • Experience with medical and dental provider contracts, including physician, hospital, and ancillary facility contracts
  • Strong knowledge of rate structures such as per diem, Medicare MS-DRG/APC, percent of charge, case rates, and stop-loss
  • Solid understanding of medical coding and terminology, including CPT, HCPCS, and ICD-10
  • Experience with claims or contract management systems
  • Strong analytical, critical-thinking, and quantitative reasoning skills
  • Ability to interpret ambiguous contract language and make defensible judgment calls
  • Proficiency with Microsoft Word, Excel, and PowerPoint
  • Strong communication, negotiation, teamwork, and organizational skills
  • Ability to manage multiple priorities and work independently under pressure
  • Bachelor's degree preferred in healthcare administration, finance, mathematics, or a related analytical field

Preferred Experience

  • Knowledge of Medicare fee schedules for institutional and physician claims
  • Experience with provider networks, reimbursement models, and payer-side contract management
  • Ability to build and test configuration rules and identify root causes of pricing errors
Benefits & Perks

Benefits

  • 401(k)
  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life insurance
  • Paid time off
  • Bonus incentives

Location

Maryland, US

Employment Type

Full-time

Experience Level

Senior

Salary Range

$75,000 - $90,000

Remote work allowed

Yes

Posted

1 month ago

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