Reimbursement Analyst I - Work From Home

Health Care Service Corporation•National, NV

5d•$63,300 - $114,300•Remote

About The Position

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. This position is responsible for developing reports based on a number of internal/external databases using common programming languages. This person will create pricing models for network negotiations and fee schedule updates used for claims adjudication and implement pricing information into the PREMIER Pricer system. Will also be responsible for validating and researching report results using the original operation systems and reporting databases as well as presenting reports to internal/external customers and responding to follow-up questions.

Requirements

Bachelor Degree in Business Administration or Computer Science with 3 years' experience in data analysis and reimbursement OR 7 years' experience to include data analysis, reimbursement analysis/modeling, and college courses.
Experience and basic understanding of reimbursement methods and financial modeling.
Health Care data experience and knowledge of Medicare pricing methodologies (RBRVS, DRG, ASC).
Verbal and written communication skills as well as interpersonal skills necessary to work in a team environment.
Analytical skills.
Self-starter with ability to work with minimal supervision to meet deadlines.
PC proficiency to include MS Office or other spreadsheet and word processing software for Windows

Nice To Haves

Technical background in BASIC programming languages.
1 year experience or more in FACETS or other Reimbursement Systems.
1 year experience with Provider contract (operations, fee schedules, rate sheets, contract lifecycle support, etc.).
1 year healthcare claims adjudication experience.

Responsibilities

Developing reports based on a number of internal/external databases using common programming languages.
Create pricing models for network negotiations and fee schedule updates used for claims adjudication.
Implement pricing information into the PREMIER Pricer system.
Validating and researching report results using the original operation systems and reporting databases.
Presenting reports to internal/external customers and responding to follow-up questions.