Reimbursement Analyst

Position Summary

Responsible for supporting reimbursement strategy through the review and interpretation of payer coverage and payment policies across Medicare, Medicare Advantage, and Commercial payers. The Analyst supports reimbursement-focused projects by analyzing reimbursement data, creating summarized Excel-based reports, and delivering insights that support accurate payment and informed business decisions.

Core Responsibilities

• Review and interpret payer coverage and payment policies across all payers as they relate to coverage, coding, and reimbursement.
• Support reimbursement projects and initiatives through policy interpretation, data analysis, and reporting.
• Conduct analytical reviews and audits related to coding, coverage, and reimbursement outcomes.
• Analyze large datasets using advanced Excel skills and develop concise summarized reports.
• Create routine and ad hoc reimbursement performance reports.
• Support LCD and NCD interpretation, edits, and system setup in collaboration with Billing and operational teams.
• Assist with reimbursement evaluation for new test launches.
• Analyze reimbursement trends, denial patterns, and payment variances.
• Perform other duties as assigned.

Experience, Education, and Qualifications

• Associate degree preferred or minimum of three (3) years of experience in reimbursement, billing, business analytics, or related healthcare industry.
• Certified Professional Coder (CPC) certification required.
• Experience reviewing and applying payer coverage and payment policies.
• Knowledge of Medicare, Medicare Advantage, and Commercial reimbursement.
• Strong analytical skills with advanced Excel proficiency (pivot tables, summaries, lookups).
• Ability to synthesize large datasets into actionable insights.
• Familiarity with oncology, pathology, molecular, or specialty testing preferred.
• Strong written and verbal communication skills.
• Ability to manage multiple projects and collaborate cross-functionally.

Benefits

• HMO and PPO options.
• Company 401(k) match.
• Employee Stock Purchase Program.
• Tuition reimbursement.
• Ledger development.
• 16 days of paid time off plus holidays.
• Wellness courses.
• Highly engaged employee resource groups.

Pay

Competitive salary based on experience and qualifications.

Schedule

Monday - Friday 8pm to 4:30pm