Reimbursement Analyst Job Description
Reimbursement Analyst Duties & Responsibilities
To write an effective reimbursement analyst job description, begin by listing detailed duties, responsibilities and expectations. We have included reimbursement analyst job description templates that you can modify and use.
Sample responsibilities for this position include:
Reimbursement Analyst Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Reimbursement Analyst
List any licenses or certifications required by the position: CPC, CPA, CCS, CCA, CMA, FHFMA
Education for Reimbursement Analyst
Typically a job would require a certain level of education.
Employers hiring for the reimbursement analyst job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Accounting, Finance, Education, Business, Business/Administration, Healthcare, Associates, Economics, Health Care, Healthcare Administration
Skills for Reimbursement Analyst
Desired skills for reimbursement analyst include:
Desired experience for reimbursement analyst includes:
Reimbursement Analyst Examples
Reimbursement Analyst Job Description
- Development and implementation of cost-savings initiatives
- Provide financial expertise when working on cross functional teams
- Work with business partners in identifying financial risks and opportunities
- Review and analyze State and Federal hospital reimbursement policy
- Provide support for the development of advocacy positions
- Analyze trends and prepare reports on current hospital finance issues for members
- Assist in coordinating communications, education sessions, and workgroup meetings based on analysis of State and Federal rules and regulatory changes
- Leading efforts with the annual budget and weekly, monthly and quarterly forecast processes
- Providing variance analysis commentary as part of the financial reporting package
- Providing financial expertise when working on cross functional teams
- Advanced skill level using MS Office software programs, including Word, Excel, PowerPoint, Access, and Outlook
- Ability to multitask and to confront new issues on a regular basis
- 3+ years in an analytical or quantitate analysis role
- Experience in healthcare and/or hospital finance
- Working with business partners in identifying financial risks and opportunities
- Analyze product profitability trends to understand financial implications
Reimbursement Analyst Job Description
- Develop financial models to drive business decisions
- Collaborate with business partners to provide analyses
- Ensure accurate allocation of direct and indirect costs
- Serve as Business Partner to a key area of the business representing approximately over 40% of the overall business
- Assist with preparing and analyzing financial forecasts/budgets
- Analyzing financial variances
- Providing financial support to key decision makers
- Creating Ad Hoc analysis from data spanning multiple systems
- Perform daily 2% audit of broker-released trade payments
- Perform audit and release of 100% of payments > = $25,000
- Bachelor’s Degree in finance, accounting or statistics
- Bachelor’s Degree in Finance, Accounting or Business field
- Minimum of three years of financial analysis or strategy experience
- Manage large amounts of data
- Must be able to sit and work at a computer for extended periods of time (5-8 hours daily)
- Minimum 3 – 5 years work experience in hospital cost reporting/finance environment required
Reimbursement Analyst Job Description
- Perform month end write-off of customer deductions to trade funds
- Provide deduction management for non-brokered customers and
- Suggest ways to improve department workflow
- Responsible for recalculation of logs after contract or reimbursement changes/updates
- Ensure accuracy of autoposted contractuals
- Monitor contract exceptions for appropriate reimbursement
- Mentoring and training team members and acting as a Subject Matter Expert (SME) for the department
- Managing informational needs of multiple cross functional stakeholders to inform of reimbursement issues and/or changes
- Acting as the primary contact with Revenue Cycle Management for payer information, payer communication and issue identification
- Supports the completion of work for cost report acceptance, wage index reviews, interim rate reviews and tentative settlements, final settlements on all types of providers as assigned
- Must demonstrates professional demeanor
- Proficiency in using PCs, Microsoft Office suite required
- At least one year of healthcare collections experience is a plus
- We require a high school diploma or GED
- BS/BA degree in related field, 2-4 years related operational and/or data analysis experience
- Proficient in statistical use of Microsoft Excel and Access or other general reporting tools, including SQL-based queries
Reimbursement Analyst Job Description
- Interacts with the provider community and provider consultants regarding payments to providers
- Focus on cost support appeals
- Assists with the preparation of financial projections
- Maintains the current revenue analysis and reporting application, Revenue Cycle Analytics (RCA) for the purpose of valuing the region’s patient accounts receivable (AR)
- Follow departmental procedures to ensure proper accumulation of all monthly statistical data to complete accurate reports
- Prepare third party cost reports at fiscal year end
- Manage contract documentation process
- Provide input to billing team and commercial leadership regarding trends in payer activity
- Identify areas for financial improvement related to payer contract behavior
- Provide analytical input for various managed care markets, payer, and/or contracts
- 2+ years health care data, mainly UB and HCFA claim content experience
- Excellent data quality assessment skills
- Bachelor’s degree required with an emphasis in healthcare administration, finance, or accounting
- One year experience in analytical work in reimbursement, financial management, managed care, or healthcare administration preferred
- Ability to prioritize duties and goals of the department
- Good communication skills both verbally and in writing required
Reimbursement Analyst Job Description
- Assist in implementation of managed care contracting strategy
- Analyze financial performance of proposed contracts
- Assist in ongoing research & working knowledge of payer policies and governmental regulations
- Monitor payer compliance with contracted payment rates and other provisions
- Assist Billing and Compliance teams in payer policy or reimbursement system audits
- Ongoing credentialing application, documentation, and renewals
- Analyze all reimbursement, including outliers, transfer adjustments
- Monitor and review new pricing configuration to assure the provider is pricing accurately as contracted
- Work with Reimbursement Specialist in developing / negotiating reimbursement rates for new providers
- Investigate all product returns and document activity in various platforms
- Prior analytical experience in healthcare industry strongly preferred
- Bachelor’s degree with an emphasis in Healthcare Administration, Accounting or Finance
- The ideal candidate would have two to three years experience in analytical work within reimbursement, physician billing and managed care
- Experience with SAP and SQL a plus
- Bachelor’s Degree in Business/Healthcare/or IT related field preferred
- Advanced knowledge of medical terminology sufficient to read and interpret CPT and ICD-9/10 manuals