Reimbursement Analyst

Role overview

Reimbursement and financial analysis

• Analyze and implement payment methodologies to establish optimal reimbursement and payment levels.
• Participate in reimbursement functions involving Medicare, Medicaid, third-party cost reports, related audits and appeals, DSH programs, 340B programs, and CPT/HCPCS code changes.
• Analyze proposed and final Medicare and Medicaid regulation changes.
• Analyze payor contract changes during negotiations and finalization; prepare contracts in Experian and Contract Maintenance.
• Research payor issues and support annual pricing and fee schedule updates, including physician compensation impacts.
• Assist with budgeting and audit processes, including monthly and year-end discounts and third-party reserves.
• Support chargemaster maintenance, new code setup, pricing, and enterprise pricing initiatives.
• Produce reports, analyze and integrate data, and complete projects accurately.
• Maintain data integrity and confidentiality, prepare understandable information, respond to questions, and support finance and accounting teams.
• Assist with policies and procedures when directed.

Qualifications

• Bachelor’s degree in business administration, finance, healthcare management, information technology, or a related field.
• Related work experience; the posting states both a minimum of two years and a minimum of one year.
• Hospital, clinic, insurance finance, or managed care reimbursement experience is preferred.
• Knowledge and experience with claim editing, groupers, provider reimbursement, and reimbursement methodologies.
• Knowledge of MS/APR DRG, APC, EAPG, CPT/HCPCS, and industry-standard coding and payment rules.

Schedule

• Full-time schedule, 40 hours per week, with 8-hour day shifts.

Work arrangement

• The posting identifies the facility as Remote ND (Fargo) and states that the role offers remote work flexibility.

Compensation

• The listed salary range is USD 24.00–38.50 per hour.

Benefits

• Benefits for eligible employees may include health, dental, vision, and life insurance, a 401(k) plan, work-life balance benefits, and paid time off.