Senior Reimbursement Analyst

Skill Requirements

• Proficiency in utilizing Microsoft Excel and other database management software
• Knowledge of EPIC
• Proven Analytic and problem-solving skills
• Understanding of cost reporting

Qualifications

• Bachelor's degree required
• Master's degree (MBA/MHA) preferred
• 3 years of hospital and physician billing and reimbursement data, data analytics required
• 5 years preferred
• Healthcare administration, finance, or related experience required
• 5+ Years in Healthcare revenue cycle preferred

Responsibilities

• Conduct in-depth evaluations of reimbursement, denial, and payment variance data to identify trends by payer, service line, provider, and operational department
• Translate complex data into actionable insights that support leadership decision making and revenue integrity
• Develop and deliver advanced reporting and dashboards that assess end-to-end revenue cycle performance, including the financial impact of front-end processes (eligibility, authorization), mid-cycle functions (coding, documentation), and back-end outcomes (denials, underpayments, net reimbursement)
• Prepare required cost reports and ensure compliance with third-party payer and regulatory reporting requirements
• Perform contract performance and reimbursement variance analysis to evaluate expected versus actual reimbursement, identify underpayments, and support payer negotiations
• Lead root cause analysis of denials and revenue leakage, quantify financial risk, and recommend data-driven process improvements to enhance net revenue realization
• Partner with revenue cycle, finance, clinical, and operational leaders to provide guidance on reimbursement strategies, implement predictive and performance-based analytics, and establish benchmarks and key performance indicators (KPIs)
• Play a critical part in advancing automation, standardization, and best practices in revenue cycle analytics to proactively mitigate risk, improve efficiency, and sustain financial performance