Hybrid Senior Reimbursement Analyst

Posted last month

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About the role

  • Analyze third-party denial trends and reimbursement issues to identify root causes and recommend corrective actions
  • Lead and support appeals initiatives, collaborating with Reimbursement Administrator, including identifying appeal opportunities, tracking outcomes, and collaborating with internal and external teams to improve success rates
  • Conduct detailed analyses of data related to existing or proposed revenue cycle projects, including payer performance and denial resolution
  • Develop and present findings through graphs, charts, written summaries, and presentations for leadership review
  • Collaborate with Revenue Cycle Operations to identify areas for improvement and support the implementation of strategic projects
  • Assist in the development and documentation of Standard Operating Procedures (SOPs) for denial management and appeals processes
  • Manage the implementation of process improvements across the revenue cycle, ensuring alignment with organizational goals
  • Provide timely and accurate updates to management on outstanding denial and appeal trends using defined systems and tracking mechanisms
  • Ensure timely follow-up on unresolved issues to minimize business risks and revenue loss
  • Stay current with payer guidelines, regulatory changes, and industry best practices related to reimbursement and appeals
  • Perform other duties as assigned

Requirements

  • Associates degree with 6+ years of experience in healthcare billings OR 8 years experience with no degree
  • Experience analyzing and manipulating large data sets in a healthcare revenue cycle setting
  • Advanced proficiency in Microsoft Excel
  • Strong knowledge of payer contracts, medical terminology, commercial and government health insurance, billing guidelines, and appeals processes
  • Proven analytical and critical thinking skills
  • Experience with data tools such as SAS, Crystal Reports, Business Objects, or similar platforms preferred
  • Excellent communication and presentation skills
  • Ability to work independently and collaboratively in a fast-paced environment

Benefits

  • Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO)
  • Tuition Reimbursement
  • Employee Stock Purchase Plan

Job title

Senior Reimbursement Analyst

Job type

Experience level

Senior

Salary

Not specified

Degree requirement

Associate's Degree

Location requirements

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