Reimbursement Analyst I

Reimbursement Analyst I University of Connecticut - 4.2 Farmington, CT Job Details Full-time | Contract 22 hours ago Qualifications Statistics Staff supervision Team supervision Spreadsheets Coding for hospital billing State healthcare regulations Health insurance knowledge Regulatory compliance analysis Healthcare compliance

Technical Proficiency Full Job Description Additional Links:

This position is Benefit eligible; click here for an overview of available benefits. This position is covered by the UHP Bargaining Unit; click here to review the current UHP Contract. This position is in salary group UHP-07; click here to review the current UHP Pay Plan Excellence, Teamwork, Leadership, and Innovation. These are the values that define UConn Health, and we are looking for team members that share these same values. Our top-rated organization is looking to add a Reimbursement Analyst 1 to our Patient Financial Services department. If you have a background in this field, as well as a passion for customer and patient experience, we want to hear from you. At UConn Health, this position is responsible for independently performing a full range of tasks in reimbursement analysis, including development of procedures to ensure recovery of all inpatient and outpatient charges, contract management, external financing reporting, revenue capture, accounts receivable analysis and regulatory compliance monitoring.

SUPERVISION RECEIVED

Works under the general supervision of an employee of higher grade.

SUPERVISION EXERCISED

May lead staff as assigned.

EXAMPLES OF DUTIES

Develops techniques for effective analyses of reimbursement trends; Reviews, analyzes and interprets insurance payments and denials to ensure proper payment; Works with billing supervisors to modify billings to meet contract specifics, as well as charge-master analyst; Recommends updates to charge-master; Develops and maintains system for tracking and evaluating performance of insurance carrier to maximize reimbursement and ensure billing compliance with audit standards; Provides reimbursement patterns and trends to the management; Prepares reports and analyses to include financial reports, setting forth progress, adverse trends and appropriate recommendations and conclusions; Submits external reports and handles all edits and changes required by meeting with appropriate departments to obtain correct data; Monitors and evaluates current reimbursement rules and changes that impact revenue capture and communicates this information to the clinical faculty, staff, and billing personnel; Provides in-service training for finance personnel; Develops and recommends policies and procedures; Schedules assigns, oversees and review work of assigned staff; Applies personnel policies and procedures; Prepares or assists in the preparation of the department budget subject to administrative review; Acts as liaison with other operating units, agencies and outside officials regarding third party reimbursements; May assist in the preparation of profit and loss statements; Performs other related duties.

MINIMUM QUALIFICATIONS REQUIRED KNOWLEDGE, SKILL, AND ABILITY

Considerable knowledge of the principles and practices of financial management; knowledge of the healthcare reimbursement; considerable ability in the interpretation and analysis of complex financial, statistical and technical data; considerable interpersonal skills, oral and written communication skills; considerable knowledge of insurance billings and collection procedures including CPT and ICD-9 coding; advanced spreadsheet and computer skills; advanced analytical skills; supervisory ability; knowledge and ability to apply relevant Federal and State laws, statutes and regulations; knowledge of statistical methodologies.

EDUCATION AND TRAINING

General Experience:

Six (6) years' experience in healthcare environment related to revenue captures, healthcare reimbursement procedures, including working knowledge of CPT and ICD-9 codes.

Substitution Allowed:

Bachelor's degree in financial management, accounting, healthcare administration or closely related field may be substituted for four (4) years of experience.

PREFERRED QUALIFICATIONS

Healthcare revenue cycle experience, specifically in reimbursement for professional billing. Underpayment identification and recovery experience, within EPIC including variance analysis against contracts or fee schedules. Demonstrated success in overturning or recovering underpaid claims. Payer and vendor communication experience, including negotiation and escalation when needed. Knowledge of payer contracts, reimbursement methodologies, and EOB/EOP interpretation. Strong analytical skills, with experience reviewing large volumes of claims and identifying patterns or discrepancies. Attention to detail and audit experience, especially with invoice or claim accuracy reviews. Ability to work independently, manage priorities, and meet recovery or resolution targets Experience with payer-related guidelines. Collaboration experience, working with internal teams such as QA, billing, contracting. Proficiency claim management systems, clearinghouses, or payer portals.

SCHEDULE

Full-time, 40 hours per week, Monday-Friday, 8:00 am to 4:30 pm with a 30 minute unpaid meal break. Why UConn Health UConn Health is a vibrant, integrated academic medical center that is entering an era of unprecedented growth in all three areas of its mission: academics, research, and clinical care. A commitment to human health and well-being has been of utmost importance to UConn Health since the founding of the University of Connecticut schools of Medicine and Dental Medicine in 1961. Based on a strong foundation of groundbreaking research, first-rate education, and quality clinical care, we have expanded our medical missions over the decades. In just over 50 years, UConn Health has evolved to encompass more research endeavors, to provide more ways to access our superior care, and to innovate both practical medicine and our methods of educating the practitioners of tomorrow.