Reimbursement Analyst

The Reimbursement Analyst is responsible for helping manage the financial resources of Hutchinson Regional Medical Center by conducting a thorough analysis on reimbursement data to create reports identifying trends by payers, Revenue Cycle, and individual staff members within the organization. The Reimbursement Analyst will regularly compile reports to provide departmental leadership with an overview of the organization’s financial performance and will also create reports to meet reporting requirements of third-party payers. This position will look for opportunities to enhance reimbursement processes and will provide consultation on reimbursement practices to mitigate denials and revenue leakage.

Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

• Maintains the Cerner reimbursement management software.
• Reviews reimbursements and variance reports to identify and trend payment discrepancies (e.g., denials, underpayments, etc.), reporting results to leadership on a regular basis
• Conducts ongoing analysis of contract compliance and financial performance for third-party payers to provide leadership with support during payer contract negotiations
• Develops performance dashboards with key performance indicators, formulas, and other reimbursement related data to track reimbursement trends for both individual staff members and the overall department

• Interprets compiled dashboard data and develops regular reimbursement reports to explain trends and identify root causes of financial performance for the organization’s financial leaders
• Analyzes dashboard data to identify potential gaps in the department’s reimbursement process flows
• Helps design and implement improvements to established or proposed reimbursement process flows to maximize potential revenue
• Stays apprised of current industry best practices and aligns departmental processes with applicable practices as needed
• Identifies and works with IT to rectify any claims data transmission issues as they arise
• Regularly evaluates departments’ performance both qualitatively and quantitatively as it relates to reimbursement
• Supports the coordination of cost reports or other information as required by government and other payers
• Acts as the designated liaison for payers, as well as for other internal departments and leadership, regarding payment accuracy
• Identifies potential sources of revenue leakage and assists in developing data-driven initiatives to resolve any issues
• Prepares journal entries, various financial or statistical analyses, reconciliations, surveys, or research activities.
• Honors organization’s mission statement, vision statement, and values.

• Performs other duties and special projects as needed.
• Abides by the Health Insurance Portability and Accountability privacy and security regulations regarding all aspects of Protected Health Information (PHI).

• Knowledge of Medicare rules and regulations.
• Strong computer and calculator skills.
• Strong accounting skills and intermediate to advanced math skills to calculate ratios and percentages.
• Demonstrated ability to communicate effectively.

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• Integrity:
  • A personal presence which is characterized by a sense of honesty and the willingness to do the right thing.
  • The ability to role model, inspire and motivate others to promote the philosophy, mission, vision, goals and values of Hutchinson Regional Healthcare System.
• Compassion:
  • A personal presence which is characterized by a sense of caring that is reflected in a high level of empathy and customer service with all that we come in contact.
  • Ability to manage conflict, consider other points of view, and offer alternative solutions without jeopardizing overall project direction and the ability to manage customer expectations.
• Accountability:
  • Demonstrated track record of ownership of situations, projects and issues.
  • Able to work autonomously and have a high degree of flexibility to adapt to changing projects, priorities and work volumes.
• Respect:
  • Demonstrated ability to collaborate with a diverse population.
  • Treat all internal and external customers with a positive, proactive service orientation.
• Excellence:
  • Strong communication and presentation skills with a proven ability to influence and lead teams to conclusion/decision making.
  • Proven ability to think strategically but also must be able to lead day-to-day tactical processes.
  • Demonstrated ability to manage and provide coaching and leadership on complex projects.
  • Must be able to lead and/or facilitate process improvement.

• Knowledge of third-party payer regulations, reimbursement, and payment policies
• Understanding of billing practices and operational workflows
• Understanding of medical terminology and medical record coding
• Proven analytic and problem-solving skills
• Strong interpersonal skills and the ability to work collaboratively
• Excellent verbal and written communication skills
• Proficiency in utilizing Microsoft Excel and other database management software
• Ability to extract and analyze relevant data
• At least 2-3 years of experience in healthcare accounting or finance required.
• High school diploma or equivalent.
• Ability to self-manage and prioritize multiple tasks

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