Hybrid Senior Reimbursement Analyst

at Highmark Health

• Job title: Senior Reimbursement Analyst
• Job type: Full Time
• Experience level: Senior
• Salary: $30 - $47 per hour
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, United States

About the role

• Senior Reimbursement Analyst at Highmark Health providing financial and operational liaison for reimbursement services. Analyzing performance metrics and recommending revenue adjustments in a healthcare environment.

Responsibilities

• This job performs wide range of third-party reimbursement services and acts as a financial and operational liaison for operations, regulatory agencies , or other outside entities.
• This incumbent serves as a technical expert on reimbursement issues for team members and management.
• The incumbent analyzes financial results, trends, performance metrics and provides root cause analysis to support business decisions.
• Recommends, based on trends and historical analysis, revenue adjustments or cost improvement measures.
• May be responsible for management and reporting functions for programs funded by federal, state, local or commercial partners through supplemental programs or value based incentive payments.
• Leads in preparation, evaluation, and maintenance of processes in support of regulatory and third party updates including quarterly work papers, annual audits, cost accounting and third party accounting.
• Communicates any issues to team and management.
• Records, classifies, and summarizes financial transactions and events in accordance with generally accepted accounting principles.
• Interprets financial transactions and events for users who make economic or business decisions.
• Provides expertise and education in budgeting, revenue recognition, reimbursement, system and process changes. Correlates Revenue/Expense to volumes and prepares reports to assess financial performance.
• Develops and/or maintains processes and performs complex calculations to support the short and long term strategic plans and operating budgets, supports monthly financial statement and comparisons of payor performance.
• Performs detailed variance analysis against expected budget, forecast, prior periods, modeling or other revenue benchmarks as required to support operations.
• Analyzes contractual or financial results, trends, performance metrics and provides root cause analysis to support business decisions.
• Recommends cost saving and revenue enhancement improvement measures.

Requirements

• Minimum Bachelor's Degree in Business, Finance, Accounting or related field, or relevant experience and/or education as determined by the company in lieu of bachelor's degree.
• Proficiency with spreadsheet applications and database management.
• Demonstrated ability to understand and apply complex federal regulations and policy.
• Preferred Master’s Degree in Business, Finance, Accounting or related field.
• 5 -7 years of Third-party reimbursement in a healthcare environment.