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 routin...