Reimbursement Analyst

Jobtailor; Hartford (CT); On-site; USD 65,000 - 85,000; Full time

Job summary

Connecticut Children's Medical Center is seeking a qualified healthcare revenue cycle specialist to analyze payments, apply contract terms, and ensure timely reimbursement in line with policy and CCMC standards.

The role leverages EPIC HB contracts, RAD reporting, and advanced data analysis to resolve payment discrepancies, monitor underpayments, and support third-party reimbursement efforts. You will coordinate payer calls and maintain confidentiality while upholding organizational values.

Qualifications

• Associate degree or equivalent experience required.
• 3–5 years healthcare revenue cycle or finance experience.
• Knowledge of ICD-10, CPT, HCPCS and medical terminology.
• Proficiency with MS Word and Excel.
• Knowledge of insurance regulations and reimbursement policies.
• Knowledge of EPIC HB Reimbursement Contracts.
• Excellent interpersonal, communication, problem-solving, and organizational skills.
• Detail oriented.
• Excellent analytical skills.
• Ability to analyze data, identify errors, and resolve problems promptly.

Responsibilities

• Analyze incoming payment information and communications from payers, physicians, and patients.
• Apply contract terms, reimbursement schedules, government regulations, and internal policies.
• Ensure CCMC is paid timely and according to contracted terms.
• Review payer payments and resolve hospital payment discrepancies through Epic work queues.
• Review communicated payer policies.
• Monitor underpaid hospital claims through full resolution.
• Coordinate and lead monthly payer calls, including sharing agendas and spreadsheets.
• Identify, document, trend, and quantify HB contract proration issues.
• Manage HB Payer Variance work queues within EPIC.
• Support billing and collection efforts related to third-party reimbursements.
• Determine whether claim balances should be written off or referred to management.
• Assist with ad hoc reimbursement requests using RAD reporting, contracts, and fee schedules.
• Maintain confidentiality and demonstrate cultural sensitivity.
• Support the organization’s mission, values, goals, and CCMC standards.

Skills

Revenue cycle

ICD-10

CPT

HCPCS

EPIC HB

Data analysis

Reimbursement policies

Discrepancy resolution

Contract terms

Ad hoc requests

Education

Associate degree

Tools

EPIC HB

MS Word

MS Excel

RAD Reporting

Job description

• Analyze incoming payment information and communications from payers, physicians, and patients
• Apply contract terms, reimbursement schedules, government regulations, and internal policies
• Ensure Connecticut Children's Medical Center is paid timely and according to contracted terms
• Review payer payments and resolve hospital payment discrepancies through Epic work queues
• Review communicated payer policies
• Monitor underpaid hospital claims through full resolution
• Coordinate and lead monthly payer calls, including sharing agendas and spreadsheets
• Identify, document, trend, and quantify HB contract proration issues
• Manage HB Payer Variance work queues within EPIC
• Support billing and collection efforts related to third-party reimbursements
• Determine whether claim balances should be written off or referred to management
• Assist with ad hoc reimbursement requests using RAD reporting, contracts, and fee schedules
• Maintain confidentiality and demonstrate cultural sensitivity
• Support the organization’s mission, values, goals, and CCMC standards

Requirements

• Associate degree required from an accredited college or university or equivalent experience
• Three to five years of healthcare revenue cycle or finance experience
• Knowledge of ICD-10, CPT, HCPC, and medical terminology
• Proficiency with MS Word and Excel
• Knowledge of insurance regulations and reimbursement policies
• Knowledge of EPIC HB Reimbursement Contracts
• Excellent interpersonal, communication, problem-solving, and organizational skills
• Detail oriented
• Excellent analytical skills
• Ability to analyze data, identify errors, and resolve problems in a timely manner

Core Competencies

Demonstrates expertise in healthcare revenue cycle management, including knowledge of ICD-10, CPT, HCPC, and reimbursement policies. Proficient in analyzing payment information and resolving discrepancies while maintaining compliance with regulations and internal policies.

Highest-signal resume keywords

• Healthcare Revenue Cycle Management
• ICD-10, CPT, HCPC Knowledge
• EPIC HB Reimbursement Contracts
• Data Analysis and Problem Resolution
• MS Word and Excel Proficiency

Hard Skills

• Healthcare Revenue Cycle Management
• ICD-10 Knowledge
• CPT Knowledge
• HCPC Knowledge
• EPIC HB Reimbursement Contracts
• Data Analysis
• Reimbursement Policies
• Payment Discrepancy Resolution
• Contract Terms Application
• Ad Hoc Reimbursement Requests

Soft Skills

• Interpersonal Skills
• Communication Skills
• Problem-Solving Skills
• Organizational Skills
• Detail Oriented

Industry Keywords

• Healthcare
• Payer Policies
• Third-Party Reimbursements
• Confidentiality
• Cultural Sensitivity

Tools & Technologies

• EPIC
• MS Word
• MS Excel
• RAD Reporting