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Salary
$65k – $179k per year (Estimated)
Location
Remote/Hybrid (Heredia, Costa Rica)
Seniority
Senior · 3+ years exp
Employment
Full-Time
Overview
Company
Impact
Profile match
Experian is a consumer credit reporting and data analytics company that traces its origins to nineteenth-century credit reference work and was established in its present form in 1996. It maintains credit files on more than a billion people and businesses, and sells scoring, decisioning, fraud prevention and marketing data to lenders, insurers and telecommunications firms, while offering consumers direct access to their own reports and monitoring. The company is registered in Dublin, listed on the London Stock Exchange, and runs its largest operations in the United States, the United Kingdom and Brazil.

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.

General Summary of Duties:

  • Informing physicians, clinics, hospitals, and other kinds of healthcare organizations via written communication about payers' changes to policies and procedures.
  • Ability to review large quantities of data, to summarize key points, and to classify into relevant categories.
  • Ability to identify medical conditions and coding to ensure the alert created is sent to the correct specialties.
  • Ability to determine the type of alert categories: Administration, Clinical, Pharmaceutical and Reimbursement and select the categories which the alert applies.

Reports to the Manager of Payer Alerts

Essential Functions:

  • Research the internet to locate drugs, conditions and diseases, medical specialties and critical information required to correlate updated health information and the types of providers requiring the information.
  • Classify information into the following categories: Administrative, Clinical, Pharmaceutical, Reimbursement, and Pre-Certification/Authorization.
  • Recognize the various types of web pages (PDF document versus html) and components/functions of a web page (bookmark).
  • 3-5 years of experience in the U.S. healthcare industry
  • Billing or claims experience

Knowledge

  • Familiarity with ICD-10, CPT, and HCPCS coding standards
  • Understanding of multiple payer types (Commercial, Medicare, Medicaid, and Managed Care)
  • General knowledge of medical specialties, provider types, and care settings
  • Basic medical terminology knowledge
  • Review and compare policy updates accurately
  • Commitment to collaboration and fostering an inclusive, team-oriented environment

Experian's recruitment process is conducted only through authorised channels. Recruitment communications will only be sent from an @experian.com email address.

Experian will never ask candidates to make any payment as part of an application, interview, assessment, onboarding, or recruitment process. To apply for roles or verify opportunities, please visit experian.com/careers.

Our benefits include: Medical, life and dental insurance, Asociacion Solidarista, International Share Save Plan, Flex Work/Work from home, Paid time off, Annual Performance Bonus, Education Reimbursement, Family Bonding, Bereavement Leave, Referral Program, and more.

At Experian, our people and culture set us apart. We're deeply committed to creating an environment where everyone feels they belong and can excel. From inclusion and authenticity to work/life balance, development, wellness, collaboration, and recognition, we focus on what truly matters. Our people-first approach has earned us global recognition: World's Best Workplaces™ 2024 (Fortune Top 25), Great Place To Work™ 2025 in 26 countries, and Glassdoor Best Places to Work 2024, among others.

Want to see what life at Experian is really like? Explore Experian Life on social or visit our Careers Site.

Experian is proud to be an Equal Opportunity Employer for all groups protected under applicable federal, state and local law, including protected veterans and individuals with disabilities. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity.

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