Senior Reimbursement Contract Analyst and Strategist

7 days ago


Marion, Illinois, United States Deaconess Full time

At Deaconess, we are seeking a skilled Senior Reimbursement Contract Analyst and Strategist to join our team.

About the Role

The Senior Reimbursement Contract Analyst and Strategist is responsible for developing and executing reimbursement strategies that drive business growth and profitability. This critical role plays a pivotal part in analyzing financial data, identifying trends, and making recommendations to senior leadership.

Key Responsibilities
  • Build and maintain complex payer contracts in Strata, ensuring seamless integration with our cost accounting module.
  • Conduct thorough pre-negotiation analysis to inform pricing strategies and measure the financial impact of various negotiation approaches.
  • Analyze actual-to-proposed rate impact trends, reviewing results post-implementation to ensure projected trends are realized and making adjustments as needed.
  • Develop and execute test scenario cases for new and updated fee schedules and contracts, ensuring accuracy and compliance.
  • Resolve complex contract issues, including identifying root causes, recommending solutions, and implementing changes as required.
  • Troubleshoot and solve a wide range of business cases and open-ended tasks, such as payment discrepancies, trend variances, and other data figures.
  • Research, analyze, and audit contract data to ensure accurate pricing and claims processing.
  • Perform ad-hoc analysis and other job-related duties as required, providing exceptional support to internal and external customers.
Requirements and Qualifications
  • Bachelor's Degree in Economics, Finance, or a related field.
  • Two to five years of progressive experience in managed care, contracting, or reimbursement, with a focus on analysis.
  • Proven analytical skills, with experience working with large datasets and performing financial impact analysis.
  • Advanced proficiency in MS Excel, including creating complex reports, utilizing lookup formulas, and working with pivot tables.
  • Familiarity with reimbursement methodologies, including DRG, Case, Per diem, APC, RBRVS, IPPS, OPPS, Multiple procedure language, and Lesser of methodologies.
  • Knowledge of claim and medical terms, including UB-04, CMS-1500, CPT, HCPCS, ICD-10, TOB, Revenue code, and Place of service.
  • Understanding of Medicaid and Medicare programs.
  • Familiarity with claims payor systems, including processing, pricing, provider contracts, and configuration.
What We Offer

We offer a competitive salary of $95,000 - $115,000 per year, depending on experience, along with a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off.



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