Reimbursement Analyst I - Work From Home

Summary

Health Care Service Corporation is a purpose-driven healthcare organization that invests in employee development. The Reimbursement Analyst I develops reports, creates pricing models for network negotiations and fee schedule updates, implements pricing information into the PREMIER Pricer system, validates report results, and presents findings to customers.

Responsibilities

• This position is responsible for developing reports based on a number of internal/external databases using common programming languages
• This person will create pricing models for network negotiations and fee schedule updates used for claims adjudication and implement pricing information into the PREMIER Pricer system
• Will also be responsible for validating and researching report results using the original operation systems and reporting databases as well as presenting reports to internal/external customers and responding to follow-up questions

Skills

• Bachelor Degree in Business Administration or Computer Science with 3 years' experience in data analysis and reimbursement OR 7 years' experience to include data analysis, reimbursement analysis/modeling, and college courses
• Experience and basic understanding of reimbursement methods and financial modeling
• Health Care data experience and knowledge of Medicare pricing methodologies (RBRVS, DRG, ASC)
• Verbal and written communication skills as well as interpersonal skills necessary to work in a team environment
• Analytical skills
• Self-starter with ability to work with minimal supervision to meet deadlines
• PC proficiency to include MS Office or other spreadsheet and word processing software for Windows
• Sponsorship will not be provided for this role
• Technical background in BASIC programming languages
• 1 year experience or more in FACETS or other Reimbursement Systems
• 1 year experience with Provider contract (operations, fee schedules, rate sheets, contract lifecycle support, etc.)
• 1 year healthcare claims adjudication experience

Qualifications

Must Haves

• Bachelor Degree in Business Administration or Computer Science with 3 years' experience in data analysis and reimbursement OR 7 years' experience to include data analysis, reimbursement analysis/modeling, and college courses
• Experience and basic understanding of reimbursement methods and financial modeling
• Health Care data experience and knowledge of Medicare pricing methodologies (RBRVS, DRG, ASC)
• Verbal and written communication skills as well as interpersonal skills necessary to work in a team environment
• Analytical skills
• Self-starter with ability to work with minimal supervision to meet deadlines
• PC proficiency to include MS Office or other spreadsheet and word processing software for Windows
• Sponsorship will not be provided for this role

Nice to Haves

• Technical background in BASIC programming languages
• 1 year experience or more in FACETS or other Reimbursement Systems
• 1 year experience with Provider contract (operations, fee schedules, rate sheets, contract lifecycle support, etc.)
• 1 year healthcare claims adjudication experience

Benefits

• Health and wellness benefits
• 401(k) savings plan
• Pension plan
• Paid time off
• Paid parental leave
• Disability insurance
• Supplemental life insurance
• Employee assistance program
• Paid holidays
• Tuition reimbursement
• Other incentives
• Annual incentive bonus plan