Job Overview
Location
Remote
Job Type
Full-time
Category
Operations
Date Posted
May 20, 2026
Full Job Description
đź“‹ Description
- • The Payment Cycle Analyst IV is responsible for conducting systemic and targeted analysis to identify reimbursement errors and determine root causes, ensuring accurate payment processing for providers and members.
- • Day-to-day responsibilities include collaborating with Configuration, IT, UAT, and Operations teams to validate requirements, develop test scripts, lead special projects, mentor junior analysts, and provide analytical support for reimbursement initiatives and regulatory compliance.
- • The role operates within CareSource Management Group Company, a mission-driven healthcare organization focused on improving access to quality care, where the Payment Cycle Team ensures payment accuracy and integrity across Medicaid, Medicare, and Marketplace lines of business.
- • The analyst will develop expertise in healthcare reimbursement systems, payment methodologies (DRG, APC, SNF, RBRVS), claims configuration, and regulatory standards (CMS, HIPAA, ACA), while building leadership and cross-functional collaboration skills through mentoring and leading complex initiatives.
🎯 Requirements
- • Bachelor’s degree or equivalent years of relevant work experience
- • Minimum of seven (7) years of health plan experience or equivalent experience with health plan operations and configuration
- • Experience with user testing
- • Advanced proficiency in Microsoft Suite (Word, Excel, PowerPoint, Access, Visio)
- • Strong analytical skills with ability to effectively communicate findings to leadership
- • Understanding of regression, unit, and user acceptance testing
🏖️ Benefits
- • Competitive salary range of $83,000.00 - $132,800.00
- • Potential for performance-based bonus tied to company and individual results
- • Comprehensive total rewards package focused on employee well-being
- • Opportunity to lead initiatives and mentor Analysts II and III
- • Remote work flexibility
Skills & Technologies
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About CareSource Management Group Company
CareSource is a nonprofit, multi-state managed care organization headquartered in Dayton, Ohio. Founded in 1989, it administers Medicaid, Medicare Advantage, and Marketplace health plans serving over two million members in Ohio, Kentucky, Indiana, West Virginia, and Georgia. The company focuses on improving health outcomes for low-income and vulnerable populations through integrated care management, behavioral health services, and social determinants programs.
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