Health Care Service Corporation

Reimbursement Analyst I - Work From Home

Health Care Service Corporation$55K — $123K *
US-AnywhereRemote in Nashville, TN
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree in Business Administration or Computer Science with 3 years' experience in data analysis and reimbursement OR 7 years' experience in data analysis and reimbursement modeling with college courses.
  • Basic understanding of reimbursement methods and financial modeling.
  • Experience with Health Care data and knowledge of Medicare pricing methodologies (RBRVS, DRG, ASC).
  • Strong verbal and written communication skills for team collaboration.
  • Proficiency in analytical skills and ability to work independently to meet deadlines.
  • PC proficiency including MS Office or similar software.

Responsibilities

  • Develop reports based on internal/external databases using programming languages.
  • Create and implement pricing models for network negotiations and fee schedule updates.
  • Validate and research report results using original operational systems.
  • Present reports to internal and external customers and handle follow-up inquiries.
  • Manage pricing information in the PREMIER Pricer system.

Benefits

  • Health and wellness benefits.
  • 401(k) savings plan and pension plan.
  • Paid time off and parental leave.
  • Disability insurance and supplemental life insurance.
  • Employee assistance program and paid holidays.
  • Tuition reimbursement and additional incentives.
Full Job Description
Job Summary

SUMMARY:
This position is responsible for developing reports based on a number of internal/external databases using common programming languages. This person will create pricing models for network negotiations and fee schedule updates used for claims adjudication and implement pricing information into the PREMIER Pricer system. Will also be responsible for validating and researching report results using the original operation systems and reporting databases as well as presenting reports to internal/external customers and responding to follow-up questions.

Required Job Qualifications:
  • Bachelor Degree in Business Administration or Computer Science with 3 years' experience in data analysis and reimbursement OR 7 years' experience to include data analysis, reimbursement analysis/modeling, and college courses.
  • Experience and basic understanding of reimbursement methods and financial modeling.
  • Health Care data experience and knowledge of Medicare pricing methodologies (RBRVS, DRG, ASC).
  • Verbal and written communication skills as well as interpersonal skills necessary to work in a team environment.
  • Analytical skills.
  • Self-starter with ability to work with minimal supervision to meet deadlines.
  • PC proficiency to include MS Office or other spreadsheet and word processing software for Windows


Preferred Job Qualifications:
  • Technical background in BASIC programming languages.
  • 1 year experience or more in FACETS or other Reimbursement Systems.
  • 1 year experience with Provider contract (operations, fee schedules, rate sheets, contract lifecycle support, etc.)
  • 1 year healthcare claims adjudication experience.


Sponsorship will not be provided for this role.

This is a Telecommute (Remote) role.

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Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Base Pay Range
$55,900.00 - $123,500.00

Exact compensation may vary based on skills, experience, and location.

About Health Care Service Corporation

Health Care Service Corporation (HCSC) is the largest customer-owned health insurer in the United States. HCSC offers a wide variety of health insurance products and related services, through its operating divisions and subsidiaries in Illinois, Montana, New Mexico, Oklahoma and Texas. HCSC's headquarters is located in Chicago, Illinois.
Learn more about Health Care Service Corporation
Size
24,000 employees
Industry
Founded
1936

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