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.