Demo

Healthcare Reimbursement Analyst

Spectrum Health
Grand Rapids, MI Full Time
POSTED ON 1/16/2025
AVAILABLE BEFORE 4/10/2025

Job Summary

Gathers and analyzes financial information in order to perform month-end close processes, prepare cost reports and assist in ad-hoc analysis. Knowledge of facility and physician reimbursement methods will be combined with data analysis and decision-making abilities to determine financial results. Serves as a liaison between other departments providing vital reimbursement information.

Essential Functions

  • Content expert / educator of annual cost reports in accordance with CMS & State of Michigan regulations. Maintains up-to-date knowledge of Medicare / Medicaid rules and regulations.
  • Facilitate the timely and accurate reporting of reimbursement information alongside general finance. Assists in reimbursement modeling, budget preparation and analysis.
  • Content expert / educator on reimbursement models. Understand and articulate reimbursement models and standards to internal and external customers. Research issues related to problems arising from reimbursement procedures. Determine root cause and take necessary action to resolve. Ensure effective communication of resolution to appropriate leadership.
  • Apply strong analytical skills and business knowledge to the investigation, analysis and recommendation of creative solutions to problems.
  • Communicates, collaborates and acts as a consultant to internal and external customers in order to resolve complicated reimbursement issues.
  • Performs routine audits to identify trends and factors contributing reimbursement rates.
  • Ensure all supporting work papers are clear and concise to meet requirements of CMS auditors as well as other internal / external auditors.
  • Monitors, develops, and improves job procedures to ensure maximum effectiveness in process and resource time spent on job tasks.
  • Monitor government program websites for timely updates as it relates to medical billing changes, pricing changes which may include ensuring fees are loaded into appropriate fee schedules according to established procedures, etc.
  • Coordinates the collection of data, review of reporting, miscellaneous projects as assigned, and identifies opportunities related to reimbursement functions.

Qualifications

Required

  • Bachelor's Degree or equivalent in health care, business management
  • 5 years of relevant experience knowledge of reimbursement, Healthcare Revenue Cycle or Finance.
  • Preferred

  • 2 years of relevant experience knowledge of reimbursement methods
  • Advanced skills in Microsoft applications including Word, PowerPoint, Excel.
  • About Corewell Health

    As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

    How Corewell Health cares for you

    Comprehensive benefits package to meet your financial, health, and work / life balance goals. Learn more .

    On-demand pay program powered by Payactiv

    Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

    Optional identity theft protection, home and auto insurance, pet insurance

    Traditional and Roth retirement options with service contribution and match savings

    Eligibility for benefits is determined by employment type and status

    Primary Location

    SITE - Corewell Health Place - 100 Corewell Drive NW - Grand Rapids

    Department Name

    Reimbursement

    Employment Type

    Full time

    Shift

    Day (United States of America)

    Weekly Scheduled Hours

    Hours of Work

    8 : 00 to 5 : 00

    Days Worked

    Monday to Friday

    Weekend Frequency

    Variable weekends

    CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

    Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

    Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

    An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

    You may request assistance in completing the application process by calling

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