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Healthcare Reimbursement Analyst
Blue Cross and Blue Shield of Louisiana. Provide analytical support in the healthcare insurance reimbursement department .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare reimbursement analysis, provider contract management, and statistical reporting. Proficient in developing and implementing reimbursement programs while ensuring compliance with billing guidelines and industry policies.
Highest-signal resume keywords
Healthcare Reimbursement AnalysisProvider Contract ManagementStatistical ReportingMicrosoft Excel ProficiencyMedical Coding Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Statistical AnalysisFinancial AnalysisBilling GuidelinesReimbursement MethodologiesContract AuditingProject DevelopmentData CompilationQuery BuildingFee Disclosure RequestsHealth-Service Utilization Analysis
Soft Skills
Analytical SkillsAttention to DetailCommunication SkillsResearch SkillsDocumentation Skills
Tools & Technologies
Microsoft ExcelMicrosoft AccessSQL Server
Industry Keywords
Healthcare InsuranceMedicareBillingCodingReimbursement ProgramsProvider AuditRFI/RFP RequestsHealth InformaticsFinancial ReportingLouisiana Residency
Tech Stack
Tools & technologiesSQL
About the role
Key responsibilities & impact- Provide analytical support in the healthcare insurance reimbursement department
- Manage hospital, physician, and other healthcare provider contracts governing billing and payments
- Develop and implement project/program narratives
- Respond to concerns regarding reimbursement programs, billing guidelines, and system requirements
- Ensure accurate implementation and maintenance of provider reimbursement programs
- Assist Network Administration, Network Operations, Information Technology, Benefits Administration, and Provider Audit staff
- Audit contracts and respond to RFI/RFP requests
- Research Medicare and other industry policies and reimbursement methodologies
- Compile fee disclosure requests and price daily claim inquiries
- Develop, implement, oversee, analyze, and report on reimbursement contracts and related billing, payment, and health-service utilization
- Design system changes, training documentation, and billing/payment guidelines
- Provide ad hoc analyses and statistical reports
- For senior-level work, independently research, analyze, develop, and maintain complex reimbursement programs and system specifications
Requirements
What you’ll need- Bachelor's degree in statistics, accounting, finance, mathematics, health informatics, or related field
- Excellent analytical, oral, and written communication skills
- Report preparation skills with the highest degree of accuracy
- Proficiency with Microsoft Excel, including Pivot Tables
- Experience with Microsoft Access or SQL Server for building queries and statistical reports
- Staff level: 2+ years of professional financial, reimbursement, or analysis experience
- Senior level: 4+ years of experience in health industry accounting functions, including billing, coding, Medicare, or statistical analysis of financial information
- Experience with medical coding and interpreting, explaining, summarizing, and making recommendations based on research and statistical analysis preferred
- Provider contract analysis and/or reimbursement program implementation experience strongly preferred
- Excellent attention to detail, research, and documentation skills
- Residency in or relocation to Louisiana preferred
- Must be authorized to work for Louisiana Blue in the United States without employer-sponsored immigration support
- Must complete background and pre-employment drug screening; employment is contingent upon satisfactory drug testing results
Benefits
Comp & perks- Resources to live well and be healthy
- Continued learning and skill development
- Professional growth opportunities
- Opportunity to serve local communities
- Smoke- and tobacco-free company properties
- Pre-employment drug screening and background screening