Real Time Eligibility Healthcare Analyst

Role overview

A contract analyst will improve real-time eligibility (RTE) operations across registration and billing workflows. The work spans configuration assessment, payer and plan mapping, benefit accuracy, staff guidance, and a practical handoff so the organization can sustain improvements. The engagement is expected to last 3–6 months and may be remote.

Responsibilities

- Review RTE configuration, errors, workflows, open tickets, and high-volume payers; prioritize fixes by impact, urgency, volume, and patient experience. - Improve payer and plan records, including mappings, synonyms, unique plan handling, and ongoing maintenance practices. - Investigate generic coverage selection and address related configuration, workflow, and staff education gaps that can affect claims routing. - Review priority hospital and professional billing payers, including 271 response sections, plan mapping, and benefit filing behavior. - Assess deductible, copay, tier, and service-type mappings to improve estimate accuracy; optimize coverage auto-creation and Medicare replacement chaining where appropriate. - Work with Patient Access on payer selection guidance, registration training, job aids, and standard workflows; document monitoring and transfer knowledge to the internal team.

Requirements

- Active experience in real-time eligibility roles. - Current RTE certification. - Ability to assess eligibility configuration, payer and plan mapping, workflows, and related operational issues. - Experience translating configuration changes into practical registration guidance and sustainable processes.

Nice to have

- Cadence or Prelude certification. - Tapestry integration experience.

Benefits and work setup

- Contract engagement of approximately 3–6 months; remote work is available. - Listed hourly range: $85–$90.