Senior Contract Analyst

Location: Remote - US

Company

hirify.global is a healthcare intelligence company providing an AI-powered platform and expertise to health plans to improve payment transparency, efficiency, and financial outcomes.

What you will do

• Maintain the authoritative inventory of payer-provider contracts, amendments, fee schedules, reimbursement policies, and effective dates.
• Review and abstract contract terms that create audit opportunities, including carve-outs, implants, devices, high-cost drugs, stop-loss thresholds, lesser-of provisions, bundling rules, and exclusions.
• Translate complex contract and policy language into clear documentation for outpatient and specialty auditors.
• Own the outpatient concept matrix, mapping active, paused, and excluded audit concepts to client-specific contracts, policies, and approvals.
• Track contract and policy gaps, updates, and client requests through resolution, partnering with Client Success, audit leadership, policy teams, and clients.
• Identify process improvements and support scaling contract intake, abstraction, change control, and quality checks.

Requirements

• Bachelor’s degree or equivalent professional experience.
• 5+ years of experience in healthcare payment integrity, provider contracting, managed care, claims auditing, or revenue cycle.
• Ability to read, interpret, and abstract payer-provider contract terms and reimbursement methodologies.
• Working knowledge of outpatient reimbursement, including OPPS/APC, fee schedules, percent of charges, carve-out structures, and payer reimbursement policies.
• Familiarity with AI tools such as Claude for contract, policy, and payer research.
• Advanced Excel skills and experience maintaining complex tracking tools or matrices.

Nice to have

• CPC, CCS, RHIA, RHIT, or RN credential.
• Experience with implants, high-cost drugs, infusion services, or other specialty audit areas.
• Background in a payer, payment integrity vendor, health system contracting department, or experience with contract management and data visualization tools.

Culture & Benefits

• Remote work within the United States.
• Fast-paced environment with shifting priorities and a high volume of detailed work.
• Equal employment opportunity workplace with reasonable accommodation support during recruitment.
• Employment is at will, and E-Verify participation is required by applicable law.