Network Reimbursement Analyst II

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

📋 Description

• Serves as a key support resource for teams tasked with the creation and upkeep of Network pricing schedules and facility reimbursement.

• Provides insights on the viability of procedural modifications.

• Functions as a consultant for the Network Provider Contracting and Network Analytics and Contract Support teams.

• Addresses inquiries related to payment processes and system configurations.

• Conducts research and analysis of Network reimbursement/payment challenges and formulates suggestions for enhancements.

• Oversees the configuration and execution of straightforward professional and facility provider pricing schedules.

⛳️ Requirements

• At least 2-3 years of experience with claims processing systems.

• Capability to analyze and interpret comprehensive reference manuals.

• Proven proficiency in utilizing Excel and database applications for data retention and manipulation.

• Exceptional mathematical, analytical, research, and organizational abilities with a keen attention to detail.

• Familiarity with medical terminology, NDC, HCPCS, and ICD-9/10-CM coding frameworks.

• Understanding of Medicare reimbursement policies and methodologies, including RBRVS.

• Minimum qualifications include a Bachelor’s Degree in business, healthcare, a related field, or equivalent business experience.

🏝️ Benefits

• Medical, Dental & Vision coverage.

• Retirement Plan.

• Generous time off including Paid Time Off, Holidays, and Volunteer time off.

• Incentive Plan.

• Tuition Reimbursement.