Senior Reimbursement Analyst

Dayton Children's Hospital•Work from Home - Hybrid - Ohio, OH

3d•Hybrid

About The Position

The Senior Reimbursement Analyst is responsible for optimizing the organization’s financial performance through comprehensive reimbursement and revenue cycle data analysis. This role conducts in depth evaluations of reimbursement, denial, and payment variance data to identify trends by payer, service line, provider, and operational department. The analyst translates complex data into actionable insights that support leadership decision making and revenue integrity. This position develops and delivers advanced reporting and dashboards that assess end to end revenue cycle performance, including the financial impact of front end processes (eligibility, authorization), mid cycle functions (coding, documentation), and back end outcomes (denials, underpayments, net reimbursement). The Senior Reimbursement Analyst prepares required cost reports and ensures compliance with third party payer and regulatory reporting requirements. In addition, the role performs contract performance and reimbursement variance analysis to evaluate expected versus actual reimbursement, identify underpayments, and support payer negotiations. The analyst leads root cause analysis of denials and revenue leakage, quantifying financial risk and recommending data driven process improvements to enhance net revenue realization. The Senior Reimbursement Analyst partners with revenue cycle, finance, clinical, and operational leaders to provide guidance on reimbursement strategies, implement predictive and performance based analytics, and establish benchmarks and key performance indicators (KPIs). This role plays a critical part in advancing automation, standardization, and best practices in revenue cycle analytics to proactively mitigate risk, improve efficiency, and sustain financial performance.

Requirements

3 years of hospital and physician billing and reimbursement data, data analytics required
Healthcare administration, finance, or related experience required
Proficiency in utilizing Microsoft Excel and other database management software
Knowledge of EPIC
Proven Analytic and problem-solving skills
Understanding of cost reporting

Nice To Haves

Master's degree (MBA/MHA) preferred
5 years preferred experience in hospital and physician billing and reimbursement data, data analytics
5+ Years in Healthcare revenue cycle preferred

Responsibilities

Optimizing the organization’s financial performance through comprehensive reimbursement and revenue cycle data analysis.
Conducting in depth evaluations of reimbursement, denial, and payment variance data to identify trends by payer, service line, provider, and operational department.
Translating complex data into actionable insights that support leadership decision making and revenue integrity.
Developing and delivering advanced reporting and dashboards that assess end to end revenue cycle performance.
Preparing required cost reports and ensuring compliance with third party payer and regulatory reporting requirements.
Performing contract performance and reimbursement variance analysis to evaluate expected versus actual reimbursement, identify underpayments, and support payer negotiations.
Leading root cause analysis of denials and revenue leakage, quantifying financial risk and recommending data driven process improvements to enhance net revenue realization.
Partnering with revenue cycle, finance, clinical, and operational leaders to provide guidance on reimbursement strategies, implement predictive and performance based analytics, and establish benchmarks and key performance indicators (KPIs).
Advancing automation, standardization, and best practices in revenue cycle analytics to proactively mitigate risk, improve efficiency, and sustain financial performance.