Reimbursement Analyst

1 week ago

Farmington, Michigan, United States Alto Health Care Staffing Full time
Schedule and Work Environment

Alto Health Care Staffing offers a 40 hour work week, primarily Monday through Friday, 8am - 4:30pm. Our team values Excellence, Teamwork, Leadership and Innovation.

Job Summary

We are seeking a skilled Reimbursement Analyst to independently perform a full range of tasks in reimbursement analysis, including development of procedures to ensure recovery of all inpatient and outpatient charges, contract management, external financial reporting, revenue capture, accounts receivable analysis and regulatory compliance monitoring.

Responsibilities
  1. Develop techniques for effective analyses of reimbursement trends.
  2. Review, analyze and interpret insurance payments and denials to ensure proper payment.
  3. Work with billing supervisors to modify billings to meet contract specifics, as well as charge-master analyst.
  4. Recommend updates to charge master.
  5. Develop and maintain system for tracking and evaluating performance of insurance carrier to maximize reimbursement and ensure billing compliance with audit standards.
  6. Provide reimbursement patterns and trends to management.
  7. Prepare reports and analyses to include financial reports, setting forth progress, adverse trends and appropriate recommendations and conclusions.
  8. Submit external reports and handle all edits and changes required by meeting with appropriate departments to obtain correct data.
  9. Monitor and evaluate current reimbursement rules and changes that impact revenue capture and communicate this information to the clinical faculty, staff, and billing personnel.
  10. Provide in-service training for finance personnel.
  11. Develop and recommend policies and procedures.
  12. Schedule, assign, oversee and review work of assigned staff.
  13. Apply personnel policies and procedures.
  14. Prepare or assist in the preparation of the department budget subject to administrative review.
  15. Act as liaison with other operating units, agencies and outside officials regarding third party reimbursements.
  16. May assist in the preparation of profit and loss statements.
Requirements

This role requires a strong understanding of reimbursement analysis and regulatory compliance. The ideal candidate will have excellent analytical and communication skills, as well as the ability to work independently and as part of a team.

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