Remote Reimbursement Analyst I — Data & Pricing Modeling

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

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.