Reimbursement Analyst Job Description

Reimbursement Analyst Job Description

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Reimbursement analyst provides expert guidance to countries and equips countries to improve exposure data quality Conducts corrections in case of exposure data quality issues with material impact on group level.

Reimbursement Analyst Duties & Responsibilities

To write an effective reimbursement analyst job description, begin by listing detailed duties, responsibilities and expectations. We have included reimbursement analyst job description templates that you can modify and use.

Sample responsibilities for this position include:

Maintain existing and develop new analytic tools related to Medicare and Medicaid reimbursement policy
Verify accuracy of Modeling Contract or Medicare/Medicaid reimbursement
Reviews and settlements of Medicare cost reports and reports results to CMS
Disbursement of Medicare funds to institutional providers
AR analysis
Lead CFO requested ad hoc reporting
Assistance with special financial and business related studies
NPV analysis for major capital expenditures and M&A
Own the budgeting and forecasting area for functional area
NPV and IRR analysis on large scale projects

Reimbursement Analyst Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Reimbursement Analyst

List any licenses or certifications required by the position: CPC, CPA, CCS, CCA, CMA, FHFMA

Education for Reimbursement Analyst

Typically a job would require a certain level of education.

Employers hiring for the reimbursement analyst job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Accounting, Finance, Education, Business, Business/Administration, Healthcare, Associates, Economics, Health Care, Healthcare Administration

Skills for Reimbursement Analyst

Desired skills for reimbursement analyst include:

Standards
Practices
Hospice
Infusion and private duty
Medical billing systems and clearing houses with special emphasis on home health
General accounting
Medicare
Proper procedures for handling exposure to communicable diseases and blood borne pathogens
Proper technique to handle exposure to hazardous material
Appeals and audits in a complex organization

Desired experience for reimbursement analyst includes:

Provide financial metrics to senior leadership team
Approve spend on projects
Manage vendor relationships, negotiate and analyzing pricing implications
Cost reduction initiative leadership
Key contributor to overall corporate FP&A and reporting function
Lead efforts with the annual budget and weekly, monthly and quarterly forecast processes

Reimbursement Analyst Examples

1

Reimbursement Analyst Job Description

Job Description Example
Our growing company is looking to fill the role of reimbursement analyst. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for reimbursement analyst
  • Development and implementation of cost-savings initiatives
  • Provide financial expertise when working on cross functional teams
  • Work with business partners in identifying financial risks and opportunities
  • Review and analyze State and Federal hospital reimbursement policy
  • Provide support for the development of advocacy positions
  • Analyze trends and prepare reports on current hospital finance issues for members
  • Assist in coordinating communications, education sessions, and workgroup meetings based on analysis of State and Federal rules and regulatory changes
  • Leading efforts with the annual budget and weekly, monthly and quarterly forecast processes
  • Providing variance analysis commentary as part of the financial reporting package
  • Providing financial expertise when working on cross functional teams
Qualifications for reimbursement analyst
  • Advanced skill level using MS Office software programs, including Word, Excel, PowerPoint, Access, and Outlook
  • Ability to multitask and to confront new issues on a regular basis
  • 3+ years in an analytical or quantitate analysis role
  • Experience in healthcare and/or hospital finance
  • Working with business partners in identifying financial risks and opportunities
  • Analyze product profitability trends to understand financial implications
2

Reimbursement Analyst Job Description

Job Description Example
Our innovative and growing company is looking to fill the role of reimbursement analyst. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for reimbursement analyst
  • Develop financial models to drive business decisions
  • Collaborate with business partners to provide analyses
  • Ensure accurate allocation of direct and indirect costs
  • Serve as Business Partner to a key area of the business representing approximately over 40% of the overall business
  • Assist with preparing and analyzing financial forecasts/budgets
  • Analyzing financial variances
  • Providing financial support to key decision makers
  • Creating Ad Hoc analysis from data spanning multiple systems
  • Perform daily 2% audit of broker-released trade payments
  • Perform audit and release of 100% of payments > = $25,000
Qualifications for reimbursement analyst
  • Bachelor’s Degree in finance, accounting or statistics
  • Bachelor’s Degree in Finance, Accounting or Business field
  • Minimum of three years of financial analysis or strategy experience
  • Manage large amounts of data
  • Must be able to sit and work at a computer for extended periods of time (5-8 hours daily)
  • Minimum 3 – 5 years work experience in hospital cost reporting/finance environment required
3

Reimbursement Analyst Job Description

Job Description Example
Our company is growing rapidly and is looking for a reimbursement analyst. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for reimbursement analyst
  • Perform month end write-off of customer deductions to trade funds
  • Provide deduction management for non-brokered customers and
  • Suggest ways to improve department workflow
  • Responsible for recalculation of logs after contract or reimbursement changes/updates
  • Ensure accuracy of autoposted contractuals
  • Monitor contract exceptions for appropriate reimbursement
  • Mentoring and training team members and acting as a Subject Matter Expert (SME) for the department
  • Managing informational needs of multiple cross functional stakeholders to inform of reimbursement issues and/or changes
  • Acting as the primary contact with Revenue Cycle Management for payer information, payer communication and issue identification
  • Supports the completion of work for cost report acceptance, wage index reviews, interim rate reviews and tentative settlements, final settlements on all types of providers as assigned
Qualifications for reimbursement analyst
  • Must demonstrates professional demeanor
  • Proficiency in using PCs, Microsoft Office suite required
  • At least one year of healthcare collections experience is a plus
  • We require a high school diploma or GED
  • BS/BA degree in related field, 2-4 years related operational and/or data analysis experience
  • Proficient in statistical use of Microsoft Excel and Access or other general reporting tools, including SQL-based queries
4

Reimbursement Analyst Job Description

Job Description Example
Our innovative and growing company is hiring for a reimbursement analyst. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for reimbursement analyst
  • Interacts with the provider community and provider consultants regarding payments to providers
  • Focus on cost support appeals
  • Assists with the preparation of financial projections
  • Maintains the current revenue analysis and reporting application, Revenue Cycle Analytics (RCA) for the purpose of valuing the region’s patient accounts receivable (AR)
  • Follow departmental procedures to ensure proper accumulation of all monthly statistical data to complete accurate reports
  • Prepare third party cost reports at fiscal year end
  • Manage contract documentation process
  • Provide input to billing team and commercial leadership regarding trends in payer activity
  • Identify areas for financial improvement related to payer contract behavior
  • Provide analytical input for various managed care markets, payer, and/or contracts
Qualifications for reimbursement analyst
  • 2+ years health care data, mainly UB and HCFA claim content experience
  • Excellent data quality assessment skills
  • Bachelor’s degree required with an emphasis in healthcare administration, finance, or accounting
  • One year experience in analytical work in reimbursement, financial management, managed care, or healthcare administration preferred
  • Ability to prioritize duties and goals of the department
  • Good communication skills both verbally and in writing required
5

Reimbursement Analyst Job Description

Job Description Example
Our company is growing rapidly and is looking to fill the role of reimbursement analyst. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for reimbursement analyst
  • Assist in implementation of managed care contracting strategy
  • Analyze financial performance of proposed contracts
  • Assist in ongoing research & working knowledge of payer policies and governmental regulations
  • Monitor payer compliance with contracted payment rates and other provisions
  • Assist Billing and Compliance teams in payer policy or reimbursement system audits
  • Ongoing credentialing application, documentation, and renewals
  • Analyze all reimbursement, including outliers, transfer adjustments
  • Monitor and review new pricing configuration to assure the provider is pricing accurately as contracted
  • Work with Reimbursement Specialist in developing / negotiating reimbursement rates for new providers
  • Investigate all product returns and document activity in various platforms
Qualifications for reimbursement analyst
  • Prior analytical experience in healthcare industry strongly preferred
  • Bachelor’s degree with an emphasis in Healthcare Administration, Accounting or Finance
  • The ideal candidate would have two to three years experience in analytical work within reimbursement, physician billing and managed care
  • Experience with SAP and SQL a plus
  • Bachelor’s Degree in Business/Healthcare/or IT related field preferred
  • Advanced knowledge of medical terminology sufficient to read and interpret CPT and ICD-9/10 manuals

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