Payer Integration Solutions Analyst

HHAeXchange

. Gather, analyze, validate, and document customer, payer, business, and technical requirements .

Posted 10/27/2026full-timeUnited StatesMid-LevelSenior💰 $70,000 - $80,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare revenue cycle management, payer operations, and claims processing, with a strong focus on configuration and integration solutions. Proficient in analyzing and documenting technical requirements while ensuring compliance and performance of payer integrations.

Highest-signal resume keywords

Healthcare Revenue Cycle ManagementPayer OperationsClaims ProcessingHealthcare Data IntegrationConfiguration-Driven Software Platforms

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer Specifications InterpretationHealthcare Electronic Data InterchangeX12 StandardsAnalytical SkillsTroubleshooting SkillsHealthcare Integration MethodsConfiguration Requirements DocumentationTesting and ValidationQuality AssuranceReimbursement Workflows

Soft Skills

Strong Written CommunicationStrong Verbal CommunicationOrganizationAttention to DetailCross-Functional Collaboration

Tools & Technologies

JiraSalesforceConfluenceSharePointSecure File Transfer ProtocolApplication Programming Interfaces

Industry Keywords

MedicaidManaged Care OrganizationClaim SubmissionPayer ResponsesRejectionsDenialsHome Care TechnologyHealth Level SevenFast Healthcare Interoperability ResourcesState Medicaid Agencies

About the role

Key responsibilities & impact

Gather, analyze, validate, and document customer, payer, business, and technical requirements
Translate payer specifications and companion guides into scalable configurations and integration solutions
Own assigned payer integration and configuration work from requirements definition through testing, validation, and production readiness
Configure and maintain payer-specific billing rules, claim submission logic, enrollment requirements, reimbursement workflows, and related system integrations
Analyze and troubleshoot implementation and production issues, identify root causes, evaluate alternatives, and implement corrective actions
Partner with Implementation, Product, Engineering, Operations, payer, and client-facing teams
Support Senior Solution Analysts on complex requirements, escalations, and broader implementation efforts
Execute testing, validation, and quality assurance activities
Support payer onboarding, production-readiness activities, enhancement requests, and ongoing optimization
Monitor and maintain payer configurations and integrations for performance, accuracy, and compliance
Create and maintain requirements, configuration decisions, test results, operating procedures, internal tools, training materials, and best-practice documentation
Provide knowledge transfer and bridge technical, operational, payer, and customer requirements
Meet service-level agreements, delivery standards, and internal procedures
Perform other duties as assigned
Travel up to 10%, including overnight travel

Requirements

What you’ll need

Four or more years of relevant experience in healthcare revenue cycle, payer operations, claims processing, healthcare technology, healthcare data integration, or healthcare software implementation
Working knowledge of Medicaid and managed care organization revenue cycle and payer processes, including claim submission, payer responses, reimbursement, rejections, and denials
Working knowledge of healthcare electronic data interchange and X12 standards, including 837, 835, 270/271, and 276/277 transactions
Experience interpreting payer specifications, companion guides, implementation requirements, and data elements; documenting business and technical requirements; and translating them into configuration or integration requirements
Experience working with configuration-driven software platforms and managing multiple implementation or configuration activities through completion
Strong analytical and troubleshooting skills
Knowledge of common healthcare integration methods and technologies, including secure file transfer protocol and application programming interfaces
Strong written and verbal communication, organization, attention to detail, discovery questioning, constructive challenge, recommendation-making, prioritization, and cross-functional collaboration
Experience with Jira, Salesforce, Confluence, or SharePoint
Ability to work on-site three days per week in the New York, Miami, or Bloomington office
Willingness to explore and adopt AI tools responsibly
Preferred experience includes home care or home care technology, healthcare software as a service, Health Level Seven or Fast Healthcare Interoperability Resources standards, or work with state Medicaid agencies, home care providers, or clearinghouses

Benefits

Comp & perks

Competitive health plans
Paid time-off
Company paid holidays
401K retirement program with a Company elected match
Other company sponsored programs
Equal-opportunity employment