Reimbursement Analyst I

🔥 13 hours ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $55.9k - $123.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Develop reports using internal and external databases and common programming languages • Create pricing models for network negotiations and fee schedule updates used for claims adjudication • Implement pricing information into the PREMIER Pricer system • Validate and research report results using original operating systems and reporting databases • Present reports to internal and external customers • Respond to follow-up questions

🎯 Requirements

• Bachelor's degree in Business Administration or Computer Science with 3 years' experience in data analysis and reimbursement, OR 7 years' experience including data analysis, reimbursement analysis/modeling, and college courses • Experience and basic understanding of reimbursement methods and financial modeling • Healthcare data experience • Knowledge of Medicare pricing methodologies (RBRVS, DRG, ASC) • Verbal and written communication skills and interpersonal skills to work in a team environment • Analytical skills • Ability to work with minimal supervision and meet deadlines • PC proficiency, including MS Office or other spreadsheet and word processing software for Windows • Sponsorship will not be provided for this role • Preferred: technical background in BASIC programming languages • Preferred: 1+ year experience in FACETS or other reimbursement systems • Preferred: 1+ year experience with provider contracts, including operations, fee schedules, rate sheets, and contract lifecycle support • Preferred: 1+ year healthcare claims adjudication experience

🏖️ Benefits

• Curated development plans and professional development opportunities • 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 • Annual incentive bonus plan • Other incentives