Reimbursement Analyst
About The Position
As a Reimbursement Professional, you will be a pivotal expert, optimizing financial outcomes through accurate, timely, and compliant claim processing. Every day, you'll meticulously manage and analyze complex reimbursement methodologies, payer contracts, and regulatory requirements to maximize revenue and minimize denials. You'll identify trends, appeal claims, and collaborate with departments and payers to resolve discrepancies, implementing efficient billing practices. To be successful, you'll combine strong analytical skills with a deep understanding of healthcare finance, meticulous attention to detail, and exceptional problem-solving and communication abilities, transforming reimbursement challenges into strategic financial advantages. Demonstrate a solid understanding of healthcare accounts receivable. Working knowledge of Payor Rules & Regulations, Understanding contract language, CCI Coding Issues, Read and interpret DOFR. Ability to determine correct systems to locate pertinent info which may include; IDX,MPV, Medical Records Systems, Insurance Payor Web Sites, Code Correct Web Site Demonstrate strong analytical skills in daily duties. Ability to demonstrate thorough knowledge and understanding when communicating with peers as well as internal and external customers. Ability to manage multiple expectations, task and deadlines effectively. Timely review of electronic communication to stay informed of changes that affect your position.
Requirements
- High School Diploma or GED
- Five years experience working in healthcare revenue cycle and/or a professional medical billing office
- One year experience with IDX Practice Management System required
- Knowledge of physician billing regulations
- Understanding of professional claims and billing procedures
- Strong MS Excel skills to interpret and analyze high volume of data
- Strong analytical skills to identify key issues from large amounts of detailed data.
- Perform root cause analysis to determine origin of issues with the aim of correction
- Ability to build and maintain working relationships with all levels of staff, physicians and other contacts
Nice To Haves
- Six years experience working in healthcare revenue cycle, in a professional medical billing office as well as experience in reviewing and interpreting contracts
- One year experience with IDX Practice Management System.
Responsibilities
- Manage and analyze complex reimbursement methodologies
- Manage payer contracts
- Manage regulatory requirements to maximize revenue and minimize denials
- Identify trends
- Appeal claims
- Collaborate with departments and payers to resolve discrepancies
- Implement efficient billing practices
- Demonstrate a solid understanding of healthcare accounts receivable
- Working knowledge of Payor Rules & Regulations
- Understanding contract language
- CCI Coding Issues
- Read and interpret DOFR
- Ability to determine correct systems to locate pertinent info which may include; IDX,MPV, Medical Records Systems, Insurance Payor Web Sites, Code Correct Web Site
- Demonstrate strong analytical skills in daily duties
- Ability to demonstrate thorough knowledge and understanding when communicating with peers as well as internal and external customers
- Ability to manage multiple expectations, task and deadlines effectively
- Timely review of electronic communication to stay informed of changes that affect your position
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
