Join our Talent Network
Skip to main content

Reimbursement Analyst

3151 S. 17Th Street
Wilmington, NC
Job ID: 6109
Date Posted: Feb 4, 2022

Returning Applicant >

Job Description

Description

About NHRMC

NHRMC, established in 1967 in Wilmington, NC, is recognized as a preeminent healthcare organization focused on leading our community to outstanding health. We have an 855 bed network of hospitals and multi-specialty physician group practices with more than 200 physicians. With a network of primary, specialty, neighborhood clinics and regional medical centers; you will find our culture is the very definition of best in practice. Join us and find out how many ways NHRMC offers you the chance to focus on what really matters - our patients and community.

About the Job

Location: NHRMC Business Center A

Department: Coding and Revenue Integrity

Full Time Equivalent: FTE: 1.000000

Work Type: 64 to 80 Hours Pay Period

Work Schedule: STD HRS - Standard-Exe or Office w flex

Exempt from Overtime: Exempt: Yes

What You'll Do

Summary:

Works under the supervision of the Department leader. The Reimbursement Analyst develops, evaluates and implements pricing strategies and tactics. This analyst is responsible for pricing strategy decisions for the facility charge master and financial analysis for various and new emerging billable services and, payment arrangements including risk models, episodic contracts and other strategic projects. Acts as a customer and team oriented resource to accomplish departmental goals in a timely, accurate, efficient and positive manner


Responsibilities:

1. This position sets, reviews, and revises pricing and mark up tables for all items in the facility CDM.

2. Researches and develop opportunities for net revenue enhancement related to pricing.

3. Analyzes legislation and regulations impacting hospital revenues.

4. Responsible for ensuring compliance with price transparency regulations and requirements including shoppable services and machine- readable file.

5. Conducting thorough analysis of internal and external factors surrounding payor negotiations and renewals as well as ongoing proposal development and evaluation

6. Utilizing internal data systems and external data to drive analyses. Data sets will include claims and clinical sources. Reconciling and verifying data to ensure data integrity and reasonableness.

7. Building one-off financial projections, decision support models and financial reporting for evolving new products, performance programs, risk models and other initiatives

8. Develops and evaluates annual chargemaster price changes and provides appropriate rate increase notices to payers.

9. Assessing competitive pricing utilizing varying data sources

10. Providing pricing support for various multi-disciplinary projects and service lines in support of pricing strategy, strategic imperatives and revenue cycle activities

11. Predicting downstream impact of changing utilization, code and CDM changes.

12. Acts as a resource to departments on charge reconciliation, revenue and usage, and accurate pricing, including creation and maintenance or pricing and charging policies and procedures.

13. Demonstrates standards of performance (ownership, teamwork, communication, compassion) that support patient satisfaction and principles of service excellence.

14. Performs other duties as assigned.

Position Requirements

Credentials:

Education:
Essential:
* Bachelor of Science
Nonessential:
* Masters Degree

Other information:

1. Education: Bachelor’s Degree in Accounting, Finance, Economics, Health Care Administration or related field required.

2. Licensure/Certifications: None required. CPA or HFMA certification preferred.

Experience: Minimum of one year of experience in data analysis required. Excellent analytical skills and ability to manipulate large data sets from multiple systems using MS Office (including Excel and Access), or other database management tool. Ability to distill data to information and recommendations and present findings of all analyses in a logical, concise manner and format required. Excellent communication skills required. Basic accounting, financial or economical analytic skills required. Ability to manage, prioritize, and take ownership of a variety of projects and demonstrate progress, meet deadlines, and bring items to closure. Comply with and proactively support departmental and organizational vision, strategic imperatives, and policies and procedures. Develop a strong team player environment, prompt open effective communication, and constructively resolve internal and external conflicts. Familiarity with current common coding practices including CPT4, ICD10CM, and DRGs as well as current Medicare reimbursement methodologies. Knowledge of pricing, healthcare finance, managed care, provider incentives, and risk contracting preferred. Understanding of healthcare alternate payment models and risk contracts for populations, a plus. Health insurance experience, a plus. SQL experience a plus. 

Other Information

This position description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications which may be required of the employee assigned to the position. Depending on the location of the job, duties may vary. Receipt of the job description does not imply nor create a promise of employment, nor an employment contract of any kind; my employment with the Company is at will.

  • Member Top 100 Hospitals – In 2016 NHRMC was recognized as a Top 100 Hospital demonstrating significant investment and financial sustainability for the communities we serve. 
  • Newsweek's 2020 list of Best Maternity Care Hospitals - NHRMC Betty H. Cameron Women's & Children's Hospital was named as a Best Maternity Care Hospital by Newsweek. 
  • Forbes America’s Best Large Employers 2018 and 2019Link 
  • Becker’s 150 Top Places to Work in HealthcareLink 
  • Healthgrades Outstanding Patient Experience

Consider a career at NHRMC and become part of this award winning team!

Share: mail

Similar Jobs

Benefits Analyst - Benefits

Wilmington, NC
STD HRS

NH-People and Culture Specialist

Wilmington, NC
STD HRS

NH-People and Culture Specialist

Wilmington, NC
STD HRS

Corporate NH - Talent Acquisition

Wilmington, NC
STD HRS

Corporate NH - Talent Acquisition

Wilmington, NC
STD HRS

Corporate NH - Talent Acquisition

Wilmington, NC
STD HRS

Corporate NH - Talent Acquisition

Wilmington, NC
STD HRS

IT Security Analyst

Wilmington, NC
STD HRS

HRIS System Manager

Wilmington, NC
STD HRS

Buyer

Wilmington, NC
STD HRS

Accounts Payable Associate (Remote)

Wilmington, NC
STD HRS

Coding Specialist III (Remote Work)

Wilmington, NC
STD HRS

Care Manager-RN - Population Health

Wilmington, NC
STD HRS

Residency Program Coord

Wilmington, NC
STD HRS