Reimbursement Analyst

Overview:

We are seeking a detail-oriented and analytical Reimbursement Analyst to join our billing and revenue team, supporting behavioral health facilities specializing in mental health and substance abuse services. This role combines expertise in medical billing, coding, and data analysis to ensure accurate reimbursement, enhance financial performance, and support payer negotiations. You will work closely with the Chief Executive Officer and Account Executive to produce financial reports and analyze reimbursement trends that impact revenue cycle.

Key Responsibilities:

Claims & Reimbursement Analysis:

Review and interpret medical and billing data to assess reimbursement accuracy and trends across payers. Identify underpayments and variances in expected vs. actual reimbursements.

Payer Negotiations:

Assist in repricing efforts and negotiations with insurance companies and third-party pricing agencies. Maintain accurate negotiation logs, ensure timely payments, and handle communications with 3rd party pricing agencies.

Financial Reporting:

Generate regular and ad hoc financial and performance reports, including financial projections, monthly accounting reports, and payer-specific reimbursement reporting

Billing & Revenue Cycle Operations:

Collaborate with billing and collections teams to streamline processes, supply necessary data and information, and optimize overall revenue cycle efficiency.

Collaboration:

Partner with the Reimbursement Manager, Account Executive, and other team members to provide insights that drive billing strategy and process improvements.

Process Improvement & Training:

Support the implementation of new systems and develop training resources on coding and billing accuracy.

Qualifications:

Education:

High school diploma or equivalent required; Associate's or Bachelor's degree in Health Information Management, Healthcare Administration, Finance, or a related field preferred.

Experience:

Finance, and/or behavioral health billing experience strongly preferred.

Technical Skills:

Proficient in Microsoft Excel (pivot tables, vlookups, macros), healthcare billing platforms, and data reporting tools (e.g., Tableau, Power BI, or SQL a plus). CollaborateMD experience strongly preferred.

Coding Knowledge:

Familiarity with ICD-9, ICD-10, CPT, DRG, and DSM coding systems. Certified Professional Coder (CPC) or equivalent certification is a plus.

Analytical & Communication Skills:

Strong attention to detail, problem-solving skills, and the ability to effectively communicate findings to both internal teams and external stakeholders.

Job Type:

Full-time Pay:

$22.00 - $26.00 per hour

Benefits:

401(k) Dental insurance Health insurance Paid time off Vision insurance Application Question(s): Do you have a LinkedIn account? If so, please share the link.

Education:

High school or equivalent (Required)

Experience:

Microsoft Excel:

2 years (Preferred)

License/Certification:

Driver's License (Required) Ability to

Commute:

Delray Beach, FL 33484 (Required)

Work Location:

In person