Senior Reimbursement Analyst (Remote)
Trinity HealthAbout the role
Employment Type:
Full timeShift:
Day ShiftDescription:
Purpose
Work Remote Position
Responsible for the data capture, analysis & reporting of data information to assist the Trinity Health leadership team achieve operational efficiency. Responsible for auditing of department information, producing reports, & suggesting improvements to processes. Provides knowledge & expertise in the program, services & applications.
Note: “patients” refers to patients, clients, residents, participants, customers, members
Essential Functions
Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.
Work Focus:
- Researches, collects & analyzes information.
- Identifies opportunities, develops solutions, & leads through resolution.
- Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience.
- Responsible for distribution of analytical reports.
Process Focus:
- Utilizes multiple system applications to perform analysis, create reports & develop educational materials.
- Incorporates basic knowledge of TH policies, practices & processes to ensure quality, confidentiality, & safety are prioritized.
- Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge.
Data Management & Analysis:
- Research & compiles information to support ad-hoc operational projects & initiatives.
- Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making.
- Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts.
Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.
Functional Role (not inclusive of titles or advancement career progression)
- Conducts prospective analysis of the potential financial impact on the member organizations of major changes in Medicare and Medicaid policies.
- Assists in related advocacy efforts regarding such regulatory changes.
- Prepares Medicare and Blue Cross home office cost reports for the Trinity Health Corporate Office and Trinity Information Systems.
- Participates in the Medicare and Blue Cross audits of Trinity Health Corporate Office, Trinity Information Systems, and the various insurance programs.
- Participates in third party payer contract negotiations, preparing impact analysis and recommendations.
- Provides analytical reimbursement support, consulting, and education to the corporate office and member organizations.
(Salary Range: $36.3426-$54.5140)
Minimum Qualifications
- Education: Bachelor’s degree in business administration, accounting, finance, informatics or related field, or an equivalent combination of education and related experience.
- 5 plus years of experience in progressively responsible operational or consulting for revenue management (e.g., reimbursement, cost reporting, forecasting, decisions support, health information management).
Additional Qualifications (nice to have)
- None
Physical & Mental Requirements & Working Conditions (General Summary)
Direct Healthcare Services / Indirect Healthcare / Support Services:
- Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell. Occasional
- Exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.). Occasional
- Exposure to or subject to noise, infectious waste, diseases & conditions. Occasional
- Exposure to interruptions, shifting priorities & stressful situations. Frequent
- Ability to follow tasks through to completion, understand & relate to complex ideas / concepts, remember multiple tasks & regimens over long periods of time & work on concurrent t
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