Reimbursement Analyst Job at Pride Health, Troy, MI

c3NZTUJxc083U2poM29LRC9WbXRaYWFVQ1E9PQ==
  • Pride Health
  • Troy, MI

Job Description

Job Description

Job Title: Finance – Reimbursement Analyst

Location: Troy, MI 48083

Work Model: Hybrid — in-office on Wednesdays. Fully remote available for exceptional candidates.

Job Category: Direct Hire

Job Summary

Under minimal supervision, the Reimbursement Analyst independently leads complex financial and data analysis to evaluate rate proposals, contract terms, and health plan reimbursement. This role proactively identifies areas for improvement in methodologies, processes, and rates, and implements solutions to optimize reimbursement across the health system.

Key Responsibilities

  • Lead financial and data analysis to assess contracted rates and reimbursement methodologies.
  • Analyze rate proposals and contract terms; evaluate financial impacts and ensure reimbursement terms are accurate and complete.
  • Develop financial reporting and analytics using tools including EPSi, SQL, Epic Clarity, and Power BI .
  • Monitor payer reporting trends and provide actionable recommendations to Contracting leadership.
  • Create and maintain metrics to compare organization reimbursement against industry benchmarks.
  • Manage the rate review process for both existing and proposed contracts.
  • Coordinate with the contract modeling team to maintain contract management/pricing systems.
  • Ensure data integrity through continuous monitoring of financial systems.
  • Stay current with reimbursement methodologies, payer policies, and regulatory changes.
  • Participate in special projects and attend committee meetings as assigned.
  • Support financial projects across the health system.

Required Skills & Abilities

  • Strong analytical and critical-thinking ability.
  • High attention to detail.
  • Proficiency in Microsoft Excel (queries, reports, pivots, What-If scenarios, database management).
  • Skilled in data extraction and reporting tools ( EPSi, SQL, Epic Clarity, Power BI ).
  • Excellent written and verbal communication skills.
  • Strong organizational and interpersonal skills.
  • Understanding of managed care reimbursement methodologies, coding, and terminology.
  • Coding/billing experience preferred.

Education

  • Bachelor’s degree required (Finance, Accounting, Business, or related field preferred).

Job Tags

Contract work, Work at office,

Similar Jobs

HORIZON HEALTH SERVICES INC

Revenue Cycle Manager Job at HORIZON HEALTH SERVICES INC

 ...Job Description Job Description The Revenue Cycle Manager will be responsible for the entire revenue cycle process which includes overseeing...  ...Revenue Cycle Manageris also responsible for the daily operational management of the Billing and Collection staff and all... 

Wegmans Food Markets

Store Security Specialist Job at Wegmans Food Markets

 ...experience is required for this position. At Wegmans, our store security teams are committed to keeping our customers and employees safe...  ...Analyze trends and data to implement a strategy to maximize sales and minimize loss due to theft Monitor activity to prevent... 

4LEAF, Inc

Public Works Inspector Job at 4LEAF, Inc

 ...The ideal candidate will be able to inspect and document construction means, methods, techniques, and sequences to evaluate the contractor's compliance with the intent of the construction documents and effectively communicate and provide updates to the Project Manager... 

Community Health Systems

Radiology Physician Assistant Job at Community Health Systems

 ...Tennova Healthcare - Clarksville is seeking a Radiology Physician Assistant to join our hospital-based imaging department. Hospital Employed Position Mix of inpatient/outpatient procedures Experience with Interventional Radiology Procedures Required 2+ years... 

Multipurpose Arena Fort Worth

Event Staff Job at Multipurpose Arena Fort Worth

 ...Job Description Job Description Part Time Event Staff Job Code: 4032 Trail Drive Management Corp Fort Worth, TX Classification: Part Time Reports to: Event Security Supervisor Job Description: The Event Staff will be responsible for a multitude of...