Healthcare Operations Analyst

Fully Remote | $67,000-$75,000 annually |Monday-Friday | 8:00 AM - 4:30 PM|Temp-to-Hire

Make an Impact in Healthcare Operations

Are you a naturally curious problem-solver who enjoys digging into complex issues, identifying root causes, and driving solutions? We're seeking a Healthcare Operations Analyst to support healthcare operations, payer policy analysis, claims investigations, contract administration, compliance initiatives, and process improvement efforts.

This opportunity is ideal for someone who thrives in a fast-paced environment, enjoys analytical work, and can effectively collaborate with cross-functional stakeholders to resolve operational challenges.

Key Responsibilities

• Analyze healthcare claims, reimbursement issues, and payer policy discrepancies.
• Conduct root cause analysis to identify and resolve operational and payment issues.
• Support contract administration, compliance activities, and operational initiatives.
• Research and resolve escalated payer and claims-related concerns.
• Review and interpret payer policies, reimbursement guidelines, and documentation requirements.
• Assist with audits, appeals, and compliance-related activities.
• Utilize Salesforce to track cases, workflows, escalations, and reporting.
• Collaborate with internal teams to improve operational processes and efficiencies.
• Maintain accurate records, documentation, and reporting.

Qualifications

Required

• 3+ years of experience in healthcare operations, payer operations, healthcare administration, claims analysis, revenue cycle, or related healthcare environments.
• Experience with healthcare claims, reimbursement, payer policies, audits, appeals, or operational analysis.
• Strong root cause analysis and investigative skills.
• Salesforce experience is required.
• Excellent communication and relationship-building skills.
• Exceptional attention to detail and organizational skills.
• Ability to learn quickly and adapt in a fast-paced environment.
• Experience with Medicare, Medicaid, and commercial insurance plans.
• Knowledge of provider contracting, credentialing, reaccreditation, or payer enrollment processes.
• Advanced reporting and data analysis skills.

What We're Looking For

• Analytical and detail-oriented mindset
• Strong problem-solving abilities
• Excellent communication skills
• Naturally inquisitive and investigative approach
• Ability to manage multiple priorities
• Comfortable working independently in a remote environment
• Passion for process improvement and operational excellence

Benefits During Contract Period

Comprehensive benefits are available through Roth Staffing, including medical, dental, vision, accident, critical illness, life insurance, short-term disability, earned sick and safe time, and employee discount programs. Coverage options begin after eligibility requirements are met.