Reimbursement and Contracting Analyst
About The Position
National Jewish Health is seeking a detail-oriented and analytically driven Reimbursement and Contracting Analyst to support reimbursement strategy and managed care performance across the organization. This role plays a critical part in ensuring accurate financial reporting, optimizing payor contract performance and supporting revenue cycle operations through data analysis and contract oversight. The Reimbursement and Contracting Analyst contributes to the design, development and application of systems solutions to support reimbursement control and financial reporting. Assists in preparing government cost reports. Monitors managed care contracting activity to ensure reimbursement is in accordance with executed agreements.
Requirements
- Bachelor’s degree in Business Administration, Health Care Administration or Accounting required.
- A minimum of three (3) years of recent and related experience in health care reimbursement field, including Revenue Cycle and/or a minimum of one (1) year experience involving analysis of managed care contracts required.
- Strong computer skills, including proficiency in Microsoft Word, Excel and Access preferred.
Responsibilities
- Prepares assigned sections of the Medicare, Medicaid and Champus/TriCare cost reports and work papers.
- Assists with the validation and analysis of the reimbursement impact of government and managed care payor audits.
- Provides data support and work paper documentation for various internal and external financial audits.
- Performs various monthly statistical reports to assist in the management of the revenue cycle. Including, but not limited to accounts receivable, patient statistics and Coding department productivity.
- Conducts ongoing studies to measure actual contract performance as compared to expected performance.
- Provides direction and assistance to all revenue cycle departments with respect to specific payor contract structure and expectations.
- Disseminates payor updates and communications to the various internal departments.
- Implements charge description master updates and revisions, including analyzing annual CPT/ HCPCS changes that may impact the various clinical, coding and revenue cycle departments.
- Coordinates managed care contracting including the negotiation, re-negotiation, enrollment and other administrative functions related to these agreements.
- Negotiates single case agreements with prospective non-contracted payors and government plans.
- Handles and assures the confidentiality of sensitive information obtained through various job responsibilities.
- Assists Patient Financial Service management on special projects that require analytical assistance.
- Assists in the preparation of the Center’s net revenue budget.
Benefits
- Comprehensive Medical Coverage: Multiple Cigna health plans for Colorado, regional office and remote employees.
- Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) available to pair with some plans.
- Generous PTO accruals to use for vacation and sick days, and six paid holidays, all compliant with Colorado state sick leave regulations.
- Dental & Vision Plans: Coverage effective the first of the month after hire.
- 403(b) plan with employer contributions after two years.
- Wellness Incentives: Earn up to $200 annually for preventive health activities.
- Tuition Reimbursement: Up to $5,250 annually for full-time and part-time employees.
- Child Care Assistance: Childcare Flex Spending Account (FSA) with annual employer contribution.
- Public Service Loan Forgiveness (PSLF) eligible employer.
- Disability & Life Insurance: Employer-paid plans and optional buy-up choices.
- Voluntary Benefits: Full suite of coverage options such as Accident, Hospital Indemnity and Legal Plan
- Exclusive Discounts: Savings on local services, insurance, and RTD bus passes.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
