Reimbursement Administrator analyzing payer performance and enhancing reimbursement strategies within healthcare revenue cycle operations. Collaborating to optimize financial performance and compliance.
Responsibilities
Analyze data related to payer performance, denials, and reimbursement trends to identify root causes and opportunities for improvement.
Develop and present high-level reports using visualizations (charts, graphs) and written summaries to communicate findings to leadership.
Partner with Revenue Cycle Operations to streamline workflows, enhance reimbursement strategies, and ensure adherence to payer and regulatory requirements.
Lead the implementation of process improvement initiatives across the revenue cycle, aligning efforts with organizational goals.
Provide regular updates to management on denial trends using established tracking systems.
Ensure timely resolution of outstanding issues to mitigate revenue loss and business risk.
Stay current with payer policies, regulatory changes, and industry best practices to support compliance and maximize reimbursement outcomes.
Support Third Party Analysts through structured training, mentoring, and expert guidance.
Perform additional duties as assigned
Requirements
Associates degree with 5+ years experience analyzing large data sets in a healthcare revenue cycle environment, OR 7+ years experience with no degree
Advanced proficiency in Microsoft Excel.
Strong understanding of payer contracts, billing guidelines, medical terminology, and appeals processes for both commercial and government payers.
Demonstrated analytical and critical thinking skills.
Experience with data tools such as SAS, Crystal Reports, Business Objects, or similar platforms (preferred).
Excellent written and verbal communication skills, including presentation capabilities.
Ability to work independently and collaboratively in a dynamic, fast-paced environment.
Production Analyst role in a tech company supporting day - to - day technology services. Collaborating with stakeholders and feature teams to enhance platform robustness and service management.
Office Assistant handling document control and office assistance for Mission Aviation Fellowship, a charitable organization serving remote communities through aviation. Managing records, office tasks, and collaborating with various departments.
Product Administrator coordinating end - to - end product development processes at Modibodi. Involves managing timelines, documentation, and supplier communication for sustainable apparel.
Wholesale team member managing orders and providing customer service to National Accounts. Supporting sales teams and coordinating logistics for product launches and campaigns.
First - level supervisor at Celestica supervising employees and ensuring routine work processes. Overseeing annual plans/objectives, budgets, and employee performance in Chonburi region.
Estates Administrator managing client estate accounts with a focus on service excellence at Aviso Wealth. Collaborating with Operations team to enhance processes and client experiences.
Transfers Administrator responsible for daily processing of transfers in financial securities firm Aviso Wealth. Collaborating with teams to provide operational support and handle escalated items.
Pet Loss Support Administrator providing essential support to the Pet Loss Support service. Managing enquiries and volunteer coordination to ensure compassionate support for pet loss.
Administrative Technician managing technical works related to personnel and administrative services. Supporting colleagues and organizational activities at the Vice - Presidency of Information Resources in a hybrid position.
Product Administration Advisor providing administrative support to Desjardins components and assisting clients and partners. Recommending solutions for standards, policies, and programs with complex problem - solving skills.