Reimbursement Analyst I - Work From Home

HCSC Group; Northern (KY); Hybrid; USD 63,000 - 114,000; Full time

Job summary

Health Care Service Corporation seeks a Reimbursement Analyst I to develop reports from multiple databases and build pricing models for network negotiations and fee schedules used in claims adjudication. You will implement pricing data into the PREMIER Pricer system and validate results.

You will present findings to internal/external customers and respond to follow-up questions, leveraging your data analysis skills and knowledge of reimbursement methodologies. This is a telecommute role.

Qualifications

• Bachelor's degree in Business Administration or Computer Science with 3 years' data analysis/reimbursement experience or 7 years of related work.
• Experience and understanding of reimbursement methods and financial modeling.
• Healthcare data experience and knowledge of Medicare pricing methodologies (RBRVS, DRG, ASC).
• Strong verbal and written communication; ability to work in a team.
• Analytical mindset and self-starter with minimal supervision.
• PC proficiency including MS Office.

Responsibilities

• Develop reports from internal/external databases using common programming languages.
• Create pricing models for network negotiations and fee schedules for claims adjudication.
• Implement pricing information into the PREMIER Pricer system.
• Validate and research report results and present findings to customers.
• Respond to follow-up questions from stakeholders.

Skills

Data analysis

Analytical skills

Communication skills

MS Office proficiency

Education

Bachelor's degree in Business Administration or Computer Science

Tools

FACETS

Reimbursement Systems

Job description

## Reimbursement Analyst I - Work From HomeApply: Remote: National Remote: Posted Today: End Date: October 6, 2026 (5 days left to apply): R0055757At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.Join HCSC and be part of a purpose-driven company that will invest in your professional development.# # **Job Summary**### SUMMARY: This position is responsible for developing reports based on a number of internal/external databases using common programming languages. This person will create pricing models for network negotiations and fee schedule updates used for claims adjudication and implement pricing information into the PREMIER Pricer system. Will also be responsible for validating and researching report results using the original operation systems and reporting databases as well as presenting reports to internal/external customers and responding to follow-up questions.### Required Job Qualifications: * Bachelor Degree in Business Administration or Computer Science with 3 years' experience in data analysis and reimbursement OR 7 years' experience to include data analysis, reimbursement analysis/modeling, and college courses.* Experience and basic understanding of reimbursement methods and financial modeling.* Health Care data experience and knowledge of Medicare pricing methodologies (RBRVS, DRG, ASC).* Verbal and written communication skills as well as interpersonal skills necessary to work in a team environment.* Analytical skills.* Self-starter with ability to work with minimal supervision to meet deadlines.* PC proficiency to include MS Office or other spreadsheet and word processing software for WindowsPreferred Job Qualifications: * Technical background in BASIC programming languages.* 1 year experience or more in FACETS or other Reimbursement Systems.* 1 year experience with Provider contract (operations, fee schedules, rate sheets, contract lifecycle support, etc.)* 1 year healthcare claims adjudication experience.Sponsorship will not be provided for this role.This is a Telecommute (Remote) role.#LI-LI1#LI-Remote### **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!**### **Pay Transparency Statement:**At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.This position may be performed remotely from anywhere within the continental United States, **excluding California, New York, Alaska, and Hawaii**.## HCSC Employment Statement:We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.# # **Base Pay Range**$63,300.00 - $114,300.00