Reimbursement analyst
Roseau, Minnesota · $26.49 to $37.09 per hour · Direct Hire · Applying is free. The employer pays our fee.
Reimbursement Analyst
The primary responsibility of the Reimbursement Analyst is to track, monitor, and recover lost revenue related to underpayments for the client. This will include reviewing accounts identified as underpaid through managed care networks and serving as a liaison with managed care company representatives to address contractual issues and denials. They will also assist in researching contract issues, developing and maintaining payor report cards, and broadly monitoring accounts receivable for other opportunities.
- Reviews historical payment information regarding provider dates of service to determine accuracy of reimbursements.
- Reviews managed care contracts to determine appropriate application of rates, provisions and terms.
- Identifies potential underpayments through comparison of managed care contracts to claim data.
- Notifies appropriate third party of potential underpayment. Commences recovery of funds through appropriate follow up with said third party.
- Manages assigned workload of accounts flagged for potential underpayments.
- Develops and maintains tools to identify and track successes of the underpayment project.
- Maintains communication with other staff who may be impacted by changes in the reimbursement field.
- Research and identifies areas of opportunity related to reimbursement.
- Collaborate with the Director to maintain individual payor report cards.
- Assist in supporting, analyzing, and researching issues with various payors, and remain educated on changing regulations impacting our reimbursement.
- All Chargemaster functions, build requirements, maintenance, support, and other related responsibilities within all Epic applications and master files.
- Perform a detailed annual review of the Chargemaster, which includes identifying codes that have been deleted, added or replaced, ensuring code reflects procedure performed, maximizing reimbursement.
- Performs other duties as assigned.
- Revenue Cycle Reporting.
Job Details:
Location: Roseau
Shift: Days
Job Schedule: M-F.
Hours: 40/wk
FTE: 1.0
*Pay Range: $26.49-$37.09
Education and Experience
Requires Bachelor's degree in accounting or business related field and 3 years of years of related business or administrative experience and knowledge of insurance billing and collection procedures, including medical coding.
Reimbursement Analyst
The primary responsibility of the Reimbursement Analyst is to track, monitor, and recover lost revenue related to underpayments for the client. This will include reviewing accounts identified as underpaid through managed care networks and serving as a liaison with managed care company representatives to address contractual issues and denials. They will also assist in researching contract issues, developing and maintaining payor report cards, and broadly monitoring accounts receivable for other opportunities.
- Reviews historical payment information regarding provider dates of service to determine accuracy of reimbursements.
- Reviews managed care contracts to determine appropriate application of rates, provisions and terms.
- Identifies potential underpayments through comparison of managed care contracts to claim data.
- Notifies appropriate third party of potential underpayment. Commences recovery of funds through appropriate follow up with said third party.
- Manages assigned workload of accounts flagged for potential underpayments.
- Develops and maintains tools to identify and track successes of the underpayment project.
- Maintains communication with other staff who may be impacted by changes in the reimbursement field.
- Research and identifies areas of opportunity related to reimbursement.
- Collaborate with the Director to maintain individual payor report cards.
- Assist in supporting, analyzing, and researching issues with various payors, and remain educated on changing regulations impacting our reimbursement.
- All Chargemaster functions, build requirements, maintenance, support, and other related responsibilities within all Epic applications and master files.
- Perform a detailed annual review of the Chargemaster, which includes identifying codes that have been deleted, added or replaced, ensuring code reflects procedure performed, maximizing reimbursement.
- Performs other duties as assigned.
- Revenue Cycle Reporting.
Job Details:
Location: Roseau
Shift: Days
Job Schedule: M-F.
Hours: 40/wk
FTE: 1.0
*Pay Range: $26.49-$37.09
Education and Experience
Requires Bachelor's degree in accounting or business related field and 3 years of years of related business or administrative experience and knowledge of insurance billing and collection procedures, including medical coding.
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