28 Senior Reimbursement Analyst Jobs in Baton Rouge, LA
SORT BY
C
R
T
B
L
Louisiana Health Service & Indemnity Company
Baton Rouge, LA | Full Time
$73k-88k (estimate)
11 Months Ago
L
Louisiana Health Service & Indemnity Company
Baton Rouge, LA | Full Time
$73k-88k (estimate)
11 Months Ago
B
Baton Rouge General Medical Center - Mid City
Baton Rouge, LA | Full Time
$72k-90k (estimate)
3 Weeks Ago
S
C
R
S
S
R
h
h
h
I
F
H
R
R
R
P
E
B
E
Senior Reimbursement Analyst
$87k-105k (estimate)
Full Time | Professional Associations
1 Week Ago
Blue Cross Blue Shield of Louisiana is Hiring a Senior Reimbursement Analyst Near Baton Rouge, LA
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSEIndependently researches, analyzes, develops and maintains new and existing, complex reimbursement programs. Designs system specifications that support claims payment and criteria for data bases that support analysis as well as training documentation describing programming, billing and payment guidelines for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business.
NATURE AND SCOPE
\
An Equal Opportunity EmployerAll BCBSLA EMPLOYEES please apply through Workday Careers.PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional InformationPlease be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.JOB CATEGORY: Data Analytics/Warehousing, & Business Intelligence
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSEIndependently researches, analyzes, develops and maintains new and existing, complex reimbursement programs. Designs system specifications that support claims payment and criteria for data bases that support analysis as well as training documentation describing programming, billing and payment guidelines for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business.
NATURE AND SCOPE
- This role does not manage people
- This role reports to this job: MANAGER, PROVIDER REIMBURSEMENT
- Necessary Contacts: In order to effectively fulfill this position the incumbent must be in contact with:All levels of internal personnel, with primary contacts in Network Administration, IT, Medical Management, Benefits Administration, Actuarial, Legal, Executive, Marketing, and Underwriting. Providers, provider representatives, consultants, provider specialty organizations, AMA, vendor reps, and hospital administrators to exchange or review program information. Other data sources are market research consultants, AMA, St. Anthony, Relative Value Studies for Dentists, Dun and Bradstreet and HIAA, CMS, Blue Cross and Blue Shield Association, Blue Cross and Blue Shield Plans, CMS, DHS, sales and marketing regional offices.
- Bachelor's degree in statistics, accounting, finance, math or related field is required
- Prefer a Master's Degree or pursuit of a Master's degree in Business, Information System and Decision Sciences, Healthcare Administration or Public Health.
- Four years of related experience can be used in lieu of a Bachelor’s degree.
- 4 years of experience in the health industry accounting functions including billing, coding, Medicare or statistical analysis of financial information is required
- Provider contract analysis and/or reimbursement program implementation experience is strongly is preferred
- Must have acquired sufficient knowledge to function autonomously and to know the appropriate contacts within departments to resolve specific issues for all lines of business.
- Excellent analytical, oral and written communication, and report preparation skills with highest degree of accuracy are required. Must have the ability to effectively present information to Executive Management and all levels of employees.
- Requires strong math/analytical skills including variance analysis, statistical formulas, algebraic formulas, percentages, multiplication and division, fractions and reasonableness tests.
- Excellent attention to detail, research, and documentation skills are required.
- Proficiency with commonly used database, spreadsheet and word processing software is required. Must have extensive knowledge to select the appropriate database format and structure for the type of information to be captured and reported. Familiarity with relational database software, mainframe capabilities, FOCUS and SQL programming is helpful and preferred. Must be able to create and maintain required databases as determined by supervisor.
- A strong understanding of physician charge practices and billing methodologies is helpful.
- Minimal travel is required. Travel may involve going to regional offices and/or conferences and exhibits.
- Staff dedicated to supporting Medicare Advantage must have working knowledge of Medicare enrollment guidelines and reimbursement.
- Pursuit of coding (CPC or CPHC) designation is preferred
- Serves as provider reimbursement technical advisor and/or committee participant to Information Technology staff, Benefits Administration staff, Provider Audit, Network Administration and/or Medicare Advantage staff, and entry level Reimbursement Analyst by developing and implementing project/program narratives and responding to concerns on new and existing reimbursement programs, billing guidelines, and system requirements to ensure accurate implementation and maintenance of provider reimbursement programs.
- Identifies claims and provider reimbursement related system problems, including claims coding and processing issues, coordinates research, audit, and recommendations with Provider Audit, and implements and monitors system changes to resolve any problems.
- Researches, designs, implements, and maintains complex hospital or professional provider reimbursement programs for traditional and managed care programs and Medicare Advantage. Contact other plans, consultants, and local providers to assist in program specifications. Proactively monitors health care and health industry developments, including CMS/Medicare eligibility, EGWP and methodology changes. Analyzes and produces management reports to monitor effectives and identify and resolve deficiencies of reimbursement programs in comparison to industry benchmarks, competitors, and Medicare.
- Leads in the development of complex financial pricing models and financial data analysis to support modifications to reimbursement programs and monitor effectiveness of pricing logic.
- Provides statistical reports to Network Administration, Medical Management, Marketing and Medicare Advantage to support internal strategies and external customer needs, such as contract negotiations and marketing efforts.
- Complies with Corporate Objectives on project implementation and schedule deadlines. Ensures proper workflow by assessing reimbursement processes and recommending improvement as well as coordinating projects and time frames with less senior reimbursement staff.
- Accountable for complying with all laws and regulations associated with duties and responsibilities.
- Perform other job-related duties as assigned, within your scope of responsibilities.
- Job duties are performed in a normal and clean office environment with normal noise levels.
- Work is predominately done while standing or sitting.
- The ability to comprehend, document, calculate, visualize, and analyze are required.
\
An Equal Opportunity EmployerAll BCBSLA EMPLOYEES please apply through Workday Careers.PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional InformationPlease be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.JOB CATEGORY: Data Analytics/Warehousing, & Business Intelligence
Job Summary
JOB TYPE
Full Time
INDUSTRY
Professional Associations
SALARY
$87k-105k (estimate)
POST DATE
06/22/2024
EXPIRATION DATE
07/18/2024
WEBSITE
bcbsla.com
HEADQUARTERS
BATON ROUGE, LA
SIZE
1,000 - 3,000
FOUNDED
1934
TYPE
Private
REVENUE
$1B - $3B
INDUSTRY
Professional Associations
Related Companies
About Blue Cross Blue Shield of Louisiana
BCBSLA is a managed health care company that provides health insurance coverage for individuals and families.
Show more
The job skills required for Senior Reimbursement Analyst include Analysis, Accounting, Written Communication, Variance Analysis, Attention to Detail, Pricing, etc. Having related job skills and expertise will give you an advantage when applying to be a Senior Reimbursement Analyst. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Senior Reimbursement Analyst. Select any job title you are interested in and start to search job requirements.
For the skill of Accounting
West Baton Rouge Parish School System
Full Time
$166k-210k (estimate)
2 Days Ago
Show more
The following is the career advancement route for Senior Reimbursement Analyst positions, which can be used as a reference in future career path planning. As a Senior Reimbursement Analyst, it can be promoted into senior positions as a Financial Analyst IV that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Senior Reimbursement Analyst. You can explore the career advancement for a Senior Reimbursement Analyst below and select your interested title to get hiring information.
Similar Jobs
Popular Articles
Top 10 Things to Avoid Putting on a Job Application
Read Article
How to Describe Your Education in a Resume
Read Article
How to Write a Memorable Cover Letter in 5 Ways
Read Article
4 Personal Finance Tips to Make During Job Transition
Read Article
4 Best Camera Setups for Interview
Read Article
Keeping a Job Search Journal: 9 Types of Journaling You Can Do
Read Article
