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Reimbursement Analyst - REMOTE
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Job Description
- Req#: 300001411269030
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Competitive salary with a comprehensive benefits package
- Opportunity for career advancement and growth within the organization
- Work closely with IT and various business teams to enhance operational efficiency
- Engaging role that involves research, analysis, and problem-solving in reimbursement methodologies
- Supportive and collaborative work environment within the Core Operations team
What to Expect (Job Responsibilities):
- Research and review state-specific Medicaid and Medicare reimbursement methodologies for providers
- Develop expertise in complex groupers utilized in reimbursement priced through PPS payment methodologies
- Support the implementation of new pricing software, including requirements development and testing
- Analyze and maintain configurable tables and files that support claim adjudication rules and provider reimbursement
- Identify automation and improvement opportunities while resolving reimbursement inquiries from internal teams and providers
What is Required (Qualifications):
- Associates Degree or equivalent combination of education and experience
- 1 - 2 years' experience in Managed Care
- Background in provider contracts, pricing configuration, claim adjudication, or reimbursement processes
- Experience processing or reviewing facility claims
- Strong analytical skills and excellent communication skills to interact with various stakeholders
How to Stand Out (Preferred Qualifications):
- Bachelor's Degree or equivalent combination of education and experience
- 3 - 5 years' experience in Managed Care
- Experience researching and resolving provider reimbursement inquiries
- Intermediate to Advanced Microsoft Excel skills
#HealthcareServices #ManagedCare #ReimbursementAnalysis #CareerOpportunity #Collaboration
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