Healthcare Reimbursement Analyst

This is a fully remote position, open to applicants in Louisiana.

📋 Description

• Provide analytical assistance within the healthcare insurance reimbursement division.

• Oversee contracts for hospitals, physicians, and other healthcare providers that dictate billing and payment processes.

• Create and implement project and program narratives.

• Address inquiries related to reimbursement programs, billing standards, and system requirements.

• Ensure the precise implementation and upkeep of provider reimbursement programs.

• Support Network Administration, Network Operations, Information Technology, Benefits Administration, and Provider Audit teams.

• Conduct audits of contracts and respond to RFI/RFP inquiries.

• Investigate Medicare and other industry policies as well as reimbursement methodologies.

• Compile fee disclosure requests and address daily claim inquiries.

• Develop, execute, supervise, analyze, and report on reimbursement contracts along with associated billing, payment, and health-service utilization.

• Design system modifications, training materials, and billing/payment protocols.

• Provide ad hoc analyses and statistical reports.

• For senior-level positions, independently research, analyze, develop, and maintain intricate reimbursement programs and system specifications.

⛳️ Requirements

• Bachelor's degree in statistics, accounting, finance, mathematics, health informatics, or a related discipline.

• Strong analytical, verbal, and written communication abilities.

• High level of accuracy in report preparation skills.

• Proficiency in Microsoft Excel, including the use of Pivot Tables.

• Experience with Microsoft Access or SQL Server for creating queries and statistical reports.

• For staff level: 2+ years of professional experience in finance, reimbursement, or analysis.

• For senior level: 4+ years of experience in health industry accounting functions, including billing, coding, Medicare, or statistical analysis of financial data.

• Preferred experience in medical coding and the ability to interpret, explain, summarize, and provide recommendations based on research and statistical analysis.

• Strongly preferred experience in provider contract analysis and/or reimbursement program implementation.

• Excellent attention to detail, research, and documentation capabilities.

• Residency in or willingness to relocate to Louisiana is preferred.

• Must be eligible to work for Louisiana Blue in the United States without employer-sponsored immigration assistance.

• Must complete a background check and pre-employment drug screening; employment is contingent on satisfactory drug testing results.

🏝️ Benefits

• Resources to promote well-being and health.

• Opportunities for ongoing learning and skill enhancement.

• Potential for professional advancement.

• Chance to contribute to local communities.

• Company properties are smoke- and tobacco-free.

• Pre-employment drug screening and background checks are required.