Payer Reimbursement Analyst Job Location Other-Remote Office ID 2024-11027 Status Full Time Shift Day Schedule Mon - Fri Hours of Work 8:00a-4:30p Responsibilities The Payer Reimbursement Analyst is charged with creating analytical reports to generate effective forecasting and predictive modeling of payer negotiations and anticipated revenue impacts. Will use critical thinking, analytical skills and appropriate decision making to analyze accounts and trends, using that feedback to model rates and forecast impact of the negotiation process. This position will interpret payment and denial data down to the line item detail, identify payer and coding trends, risks, and identify key recommendations and impacts of our health plan negotiation process. Essential to this position are strong quantitative, analytical and organizational skills. Excellent communication and interpersonal skills with the ability to effectively interpret, communicate, and educate others. Analyze billing practices, denial reasons, and payer reimbursement to identify and share payment related issues prior to negotiations. Review volumes, trends, average length of stay, current reimbursement compared to established rates, DSO and other payer measures to ensure plan is paying according to the agreement. Forecast budget impact related to changes in rates. Create and use predictive modeling to ensure rate impacts are agreeable for Hazelden Betty Ford. Support the patient accounts team to understand trends with front end claim errors/failures, creating corrective action plans in the form of edits, workflows, etc. to reduce reoccurrence. Thorough knowledge of payer policies, subscriber benefits, non-covered services, coding and diagnosis issues and accounts receivable. Compiles, analyzes, and reports on data related to underpayments, denials, revenue opportunities and revenue leakage. With the Vice President of Payer Relations create communication plans internally and externally to improve processes and standard work to solve for these issues. Conduct detailed analyses of data and information relating to A/R trends and reimbursement. Summarize research findings into graphs, charts, written summaries and presentations for review by leadership and explain/interpret results upon request. Qualifications Required Qualifications: Associate degree in business or related field Minimum 5 Years' experience in the healthcare industry Proficient in: Excel, Power BI, Cerner and/or FinThrive Knowledge and understanding of revenue analytics, contract analytics and payment modeling Ability to learn and adapt quickly to new healthcare technology systems, processes and procedures to ensure a working knowledge to be able to effectively provide quality analysis. Strong written and oral communication skills Preferred Qualifications: Bachelor's degree in business, healthcare or analytics. Experience in a hospital or behavioral health business office dealing with patient billing or patient accounting. Working knowledge: Microsoft Visio, and Adobe Experience presenting complex models to executive leaders Min USD $93,491.00/Yr. Max USD $131,987.00/Yr. Overview The Hazelden Betty Ford Foundation is the largest nonprofit addiction recovery organization in the United States. It is also one of the most mission-driven places you will find. The Hazelden Betty Ford Foundation team is passionate about providing hope and ultimately healing. As a living, growing and evolving institution, the Hazelden Betty Ford Foundation is - at our core- a people-powered organization. Hazelden Betty Ford Foundation is comprised of 1600+