Hazelden Betty Ford Foundation-posted 3 months ago
$82,239 - $119,838/Yr
Full-time • Mid Level
Center City, MN
1,001-5,000 employees

The Payer Reimbursement Analyst is charged with creating analytical reports to generate effective forecasting and predictive modeling of payer negotiations and anticipated revenue impacts. Will use critical thinking, analytical skills and appropriate decision making to analyze accounts and trends, using that feedback to model rates and forecast impact of the negotiation process. This position will interpret payment and denial data down to the line item detail, identify payer and coding trends, risks, and identify key recommendations and impacts of our health plan negotiation process. Essential to this position are strong quantitative, analytical and organizational skills. Excellent communication and interpersonal skills with the ability to effectively interpret, communicate, and educate others. Analyze billing practices, denial reasons, and payer reimbursement to identify and share payment related issues prior to negotiations. Review volumes, trends, average length of stay, current reimbursement compared to established rates, DSO and other payer measures to ensure plan is paying according to the agreement. Forecast budget impact related to changes in rates. Create and use predictive modeling to ensure rate impacts are agreeable for Hazelden Betty Ford. Support the patient accounts team to understand trends with front end claim errors/failures, creating corrective action plans in the form of edits, workflows, etc. to reduce reoccurrence. Thorough knowledge of payer policies, subscriber benefits, non-covered services, coding and diagnosis issues and accounts receivable. Compiles, analyzes, and reports on data related to underpayments, denials, revenue opportunities and revenue leakage. With the Vice President of Payer Relations create communication plans internally and externally to improve processes and standard work to solve for these issues. Conduct detailed analyses of data and information relating to A/R trends and reimbursement. Summarize research findings into graphs, charts, written summaries and presentations for review by leadership and explain/interpret results upon request.

  • Create analytical reports for forecasting and predictive modeling of payer negotiations and revenue impacts.
  • Analyze accounts and trends to model rates and forecast negotiation impacts.
  • Interpret payment and denial data to identify trends and risks.
  • Analyze billing practices and denial reasons to identify payment issues.
  • Review volumes, trends, and reimbursement rates to ensure compliance with agreements.
  • Forecast budget impacts related to changes in rates.
  • Support patient accounts team in understanding claim errors and creating corrective action plans.
  • Compile and analyze data related to underpayments, denials, and revenue opportunities.
  • Create communication plans to improve processes with the Vice President of Payer Relations.
  • Conduct detailed analyses of A/R trends and reimbursement.
  • Bachelor’s degree in business or related field or Associate’s degree plus 4 years of directly related work experience.
  • Minimum 4 years of experience in the healthcare industry.
  • Proficient in Excel, Power BI, Cerner and/or Fin Thrive.
  • Knowledge of revenue analytics, contract analytics, and payment modeling.
  • Ability to learn and adapt quickly to new healthcare technology systems.
  • Strong written and oral communication skills.
  • Bachelor’s degree in business, healthcare, or analytics.
  • Experience in a hospital or behavioral health business office dealing with patient billing or patient accounting.
  • Working knowledge of Microsoft Visio and Adobe.
  • Experience presenting complex models to executive leaders.
  • Competitive Health, Dental and Vision Plans
  • Retirement savings plan with employer match
  • Paid time-off
  • Tuition reimbursement
© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service