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Healthcare Reimbursement Analyst
2 months ago
Position Overview:
We are seeking a dedicated professional to join our team as a Reimbursement Analyst. This role is essential in ensuring the financial integrity of our healthcare services through effective contract analysis and reimbursement strategies.
About UofL Health:
UofL Health is a comprehensive regional academic health system, committed to delivering advanced patient care through a network of hospitals, medical centers, and specialized institutes. Our mission is to enhance community health through innovative and compassionate care.
Role Summary:
The Reimbursement Analyst will collaborate with various departments to analyze vendor applications and ensure that expected reimbursements align with contractual agreements. This position requires a keen understanding of reimbursement workflows and the ability to interpret complex contract information.
Key Responsibilities:
- Utilize advanced reporting tools to conduct data analysis and identify trends related to underpayments.
- Serve as the subject matter expert on pricing models based on contract reimbursement methodologies.
- Facilitate training sessions for team members on reimbursement processes and pricing calculations.
- Collaborate with financial counselors and other stakeholders to assess accounts and generate pricing estimates for medical procedures.
- Ensure compliance with organizational policies and maintain high standards of conduct.
- Perform additional duties as assigned to support departmental objectives.
Essential Functions:
- Enhance the use of current pricing tools and assist in the development of new tools for reimbursement analysis.
- Generate reports on payment variances to address underpayment challenges.
- Provide pricing estimates for patients and registration staff based on contractual agreements.
- Validate new contracts and amendments to ensure accurate payment models.
- Prepare regular and ad-hoc reports for reimbursement audits and departmental reviews.
- Analyze late charges to determine their appropriateness for rebilling or write-off.
- Support management in maximizing information systems to monitor service profitability and denial trends.
Qualifications:
Education:
Associate's degree in business, healthcare, accounting, or a related field is required. A Bachelor's degree is preferred.
Experience:
Minimum of three years of relevant experience in the healthcare sector, particularly in contract modeling or reimbursement analysis. Familiarity with hospital billing processes for various payers is essential.
Skills and Abilities:
Strong analytical skills with attention to detail, excellent organizational abilities, and effective communication skills are critical for success in this role. Proficiency in Microsoft Office and experience with reimbursement modeling systems are preferred.
Commitment to Excellence:
Demonstrate professionalism and uphold organizational values through conduct and demeanor. Maintain confidentiality and adhere to safety standards at all times.
