Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.
Reimbursement Analyst
Location
United States
Posted
3 days ago
Salary
Not specified
No structured requirement data.
Job Description
Role Description
As a Reimbursement Professional, you will be a pivotal expert, optimizing financial outcomes through accurate, timely, and compliant claim processing.
- Manage and analyze complex reimbursement methodologies, payer contracts, and regulatory requirements to maximize revenue and minimize denials.
- Identify trends, appeal claims, and collaborate with departments and payers to resolve discrepancies.
- Implement efficient billing practices.
- Demonstrate a solid understanding of healthcare accounts receivable.
- Work knowledge of Payor Rules & Regulations, understanding contract language, CCI Coding Issues, and read and interpret DOFR.
- Determine correct systems to locate pertinent information, which may include IDX, MPV, Medical Records Systems, Insurance Payor Websites, and Code Correct Website.
- Demonstrate strong analytical skills in daily duties.
- Communicate effectively with peers as well as internal and external customers.
- Manage multiple expectations, tasks, and deadlines effectively.
- Timely review of electronic communication to stay informed of changes that affect your position.
Qualifications
- High School Diploma or GED.
- Five years experience working in healthcare revenue cycle and/or a professional medical billing office.
- One year experience with IDX Practice Management System required.
- Knowledge of physician billing regulations.
- Understanding of professional claims and billing procedures.
- Strong MS Excel skills to interpret and analyze high volume of data.
- Strong analytical skills to identify key issues from large amounts of detailed data.
- Ability to build and maintain working relationships with all levels of staff, physicians, and other contacts.
Requirements
- Six years experience working in healthcare revenue cycle, in a professional medical billing office as well as experience in reviewing and interpreting contracts.
- One year experience with IDX Practice Management System.
Job Requirements
- High School Diploma or GED.
- Five years experience working in healthcare revenue cycle and/or a professional medical billing office.
- One year experience with IDX Practice Management System required.
- Knowledge of physician billing regulations.
- Understanding of professional claims and billing procedures.
- Strong MS Excel skills to interpret and analyze high volume of data.
- Strong analytical skills to identify key issues from large amounts of detailed data.
- Ability to build and maintain working relationships with all levels of staff, physicians, and other contacts.
- Six years experience working in healthcare revenue cycle, in a professional medical billing office as well as experience in reviewing and interpreting contracts.
- One year experience with IDX Practice Management System.
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