Key Facts

Remote From:

Costa Rica

Category: Business Analyst

Full time

Mid-level (2-5 years)

English

Hard Skills

Health Reimbursement Arrangement CPT Coding ICD Coding (ICD-9/ICD-10) Salesforce JIRA Microsoft 365 Business Intelligence Tools

Other Skills

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Microsoft Excel
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Adaptability
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Collaboration
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Problem Solving

Roles & Responsibilities

2-3 years of healthcare reimbursement and coding experience
Good knowledge and experience in using Salesforce, Atlassian JIRA, Microsoft 365 applications
High-level knowledge of CPT, HCPCs, and ICD-10 coding language
Adaptable to changing environment and workload

Requirements:

Interpret medical rules, regulations, fee schedules, and edits from payers
Understand and manipulate payer data to build coding and financial tables
Monitor and maintain tables due to unpredictable payer updates
Analyze and maintain Medicaid master fee schedules

Experian

Information Technology & Services

About Experian

Experian unlocks the power of data to create opportunities for consumers, businesses and society. During life’s big moments – from buying a home or car, to sending a child to college, to growing a business exponentially by connecting it with new customers – we empower consumers and our clients to manage data with confidence so they can maximize every opportunity. We gather, analyse and process data in ways others can’t. We help individuals take financial control and access financial services, businesses make smarter decision and thrive, lenders lend more responsibly, and organizations prevent identity fraud and crime. For more than 125 years, we’ve helped consumers and clients prosper, and economies and communities flourish – and we’re not done. Our 16,000 people in 37 countries believe the possibilities for you, and our world, are growing. We’re investing in new technologies, talented people and innovation so we can help create a better tomorrow. About Experian: Bringing data to life requires creativity, passion, flexibility and expertise. We want you to share in our success. That's why we offer rewards that recognise great performance. Working in a culture of collaboration, achievement and respect we will give you the support and encouragement you need to develop your skills and talents and progress your career. Everyday our people bring enthusiasm, innovation and inspiration to work and if this sounds like you connect with us at Experian. Read more at https://www.experianplc.com/careers/ Please note only shortlisted candidates will be contacted Our diverse workforce is part of the reason for our success. We want everyone to succeed, irrespective of their gender, ethnicity, sexuality, physical ability or age.

Company type: XLarge

Industry: Information Technology & Services

Founded: 2018

Company size: 10001

Website LinkedIn See all jobs →

Job description

Company Description

Experian is a global data and technology company, powering opportunities for people and businesses around the world. We operate across a range of markets, from financial services to healthcare, automotive, agribusiness, insurance, and many more. Experian invests in people and new advanced technologies to unlock the power of data. We have an amazing team of 25,200 people in 32 countries.

Job Description

Interpret medical rules, regulations, fee schedules, and edits that payers post. Sources include (but may not be limited to Centers for Medicare Services "CMS", State Health & Human Services Medicaid plans, Governmental payer Tricare, and all national commercial insurance plan payers that pay). You will report to Client Implementation Senior Manager.

Understand and manipulate payer data to build federal, state, and commercial coding and financial tables that support Experian Health product logic.
Monitor and maintain the tables, due to unpredictable payer updates. Navigate complex and evolving regulatory scenarios.
Analyze and maintain Medicaid master fee schedules.
Think through situations independently and in collaboration with others.
Maximize the efficiency and use of our product solutions in day-to-day operations by properly maintaining payer specific edits.
Leverage internal loading systems to routinely load advanced edit tables in testing and production environments.

Have an openness and willingness to support and navigate automation and AI technologies.

Qualifications

2-3 years of healthcare reimbursement and coding experience is preferred.
Good knowledge and experience in using Salesforce, Atlassian JIRA, Microsoft 365 applications, with great proficiency in Excel and other data analytics tools.
High-level knowledge of CPT, HCPCs, and ICD-10 coding language to ensure the accuracy of coding edit files.

Adaptable to changing environment and workload when necessary.

Additional Information

Our uniqueness is that we celebrate yours. Experian's people first, inclusive and purpose-driven culture is multi award-winning; World's Best Workplaces™ 2025 (Fortune Global Top 25), Great Place To Work™ in 26 countries to name a few. Check out Experian Life on social or explore our Careers Site to understand why. Experian is also proud to be an Equal Opportunity and Affirmative Action employer. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity.

Benefits/Perks:

Great compensation package and bonus plan
Core benefits including medical, dental, vision, and matching 401K
Flexible work environment, ability to work remote, hybrid or in-office
Flexible time off including volunteer time off, vacation, sick and 12-paid holidays
Explore all our exciting benefits here: https://yourexperianbenefits.com/cand-index.html
This role offers the flexibility to work from home as needed.

#LI-Remote This is a remote position.

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