Reimbursement Analyst

About the role

This position offers a unique opportunity to lead and contribute to strategic Provider Network Economics initiatives that directly influence reimbursement strategy, provider partnerships, operational performance, and organizational financial results. The role provides significant exposure to senior leadership, extensive cross-functional collaboration, and the opportunity to shape innovative payment models that support high-quality, affordable healthcare. You will join a high-performing and highly collaborative team that values initiative, intellectual curiosity, and a growth mindset. The position also offers the flexibility of working remotely, enabling team members to collaborate effectively while maintaining a healthy work-life balance.

The Reimbursement Analyst provides analytical and reimbursement related support to operating segments across the Sanford Enterprise, working with all operating segments.

Responsibilities

• Assist in analyzing and implementing new payment methodologies to establish optimal reimbursement and payment levels
• Participate in the implementation and monitoring of reimbursement functions, including Medicare, Medicaid, or other third-party cost reports, related audits, appeals, disproportionate share hospital (DSH) programs, drug discount programs (340B), and CPT/HCPCS code changes
• Prepare impact analyses of payor proposed and final Medicare and Medicaid regulation changes
• Assist with impact analysis of payor contract changes during negotiations and finalizations of contracts
• Prepare third-party payor contracts in Experian and Contract Maintenance (hospital and clinic payment integrity tools)
• Research third-party payor issues
• Support annual pricing and fee schedule updates, including impacts on physician compensation
• Assist in annual budgeting and audit processes such as monthly discounts, year-end discounts, and third-party reserves
• Provide ongoing support to operations and CDM team in maintaining chargemasters, particularly setting up new codes and establishing prices
• Assist in ongoing pricing initiatives across the enterprise
• Produce reports, analyze and integrate data, and complete other projects accurately and efficiently
• Promote integrity and confidentiality of data when sharing with others
• Prepare data in a useful and understandable format
• Accept and respond to questions and challenges regarding information provided
• Support relationships with finance and accounting staff across the enterprise
• Serve as a resource for individuals while providing reimbursement and accounting support
• Review and assist in revising policies and procedures when directed

Qualifications

• Bachelor's degree required in business administration, finance, healthcare management, information technology (IT), or related field
• Minimum two years of related work experience, preferably in hospital, clinic, or insurance finance and/or managed care reimbursement
• Demonstrated knowledge and experience in healthcare reimbursement related to claim editing, groupers, provider reimbursement, and methodologies (MS/APR DRG; APC, EAPG, CPT/HCPCS) industry standard coding and payment rules
• Minimum one year of related work experience, preferably in hospital, clinic, or insurance finance and/or managed care reimbursement

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• Life insurance
• 401(k) retirement plan
• Work/life balance benefits
• Generous time off package

For more information about Total Rewards, visit sanfordcareers.com/benefits.

Pay

Hourly salary range: $24.00 – $38.50

Schedule

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

Requisition: R-0278269 | Job Function: Finance