UPMC Hillman Cancer Center is hiring a Reimbursement Analyst to manage all aspects of provider reimbursement. In this middle-level analytical role, you will establish and maintain compensation rates for hospitals, physicians, and ancillary services.
What You'll Do
- Work with a Reimbursement Specialist to develop and negotiate reimbursement rates for new providers.
- Monitor new pricing configurations to ensure accurate provider pricing as contracted.
- Resolve reimbursement issues and problems that result in claims pending.
- Update and maintain hospital reimbursement rate summaries and reports for all product lines.
- Act as the company expert on all reimbursement issues.
- Complete special projects accurately and timely.
- Handle out-of-network negotiations when required.
- Monitor calendars to proactively assure all action items are completed.
- Work with configuration staff to ensure negotiated rates are operational.
- Analyze and compare fee schedules.
- Analyze all reimbursement, including outliers and transfer adjustments.
- Attend meetings when required.
What We're Looking For
- A Bachelor's Degree in health care administration, business, or a related discipline (related experience in a health care administration setting may be substituted).
- Excellent planning, communication, documentation, organizational, analytical, and problem-solving abilities.
- Advanced mathematical skills.
- Ability to interpret and summarize analysis results in a timely and meaningful way.
- Strong computer skills, including expert knowledge of Access and Excel.
- Ability to work cooperatively with multidisciplinary teams and/or independently.
- Ability to re-engineer processes to positively impact productivity in timeliness and accuracy.
Nice to Have
- Experience with a physician practice, hospital, ancillary provider, health insurance company, or integrated delivery system.
- In-depth understanding of managed care delivery systems and direct experience with reimbursement.
- Knowledge of ICD-9CM, CPT4, Revenue Codes, DRGs, base rates, Medicare/Medicaid methodologies, HCPCS coding, and related governmental guidelines.
Technical Stack
- Microsoft Access
- Microsoft Excel
UPMC is an Equal Opportunity Employer/Disability/Veteran.
