Healthcare Reimbursement Analyst

Louisiana Health Service & Indemnity Company (Louisiana Blue) is hiring Reimbursement Analysts at the Associate, Analyst, or Senior level for its Provider Reimbursement team. The role supports the development, implementation, analysis, and maintenance of healthcare provider reimbursement programs and contracts, including billing guidelines, payment systems, and related inquiries.

Responsibilities:

• Reporting to the manager of the team,  we assist Network Administration staff, Network Operations staff, Information Technology staff, Benefits Administration staff, Provider Audit staff by developing and implementing project/program narratives and responding to concerns on new and existing reimbursement programs, billing guidelines, and system requirements to ensure accurate implementation and maintenance of provider reimbursement programs, under the direction of the departmental director and working closely with more senior level reimbursement staff
• Responds to ad hoc requests such as auditing of contracts, responses to RFI/RFPs, researching Medicare and other industry policies and reimbursement methodologies
• Compiles fee disclosure requests and pricing of daily claim inquiries from various sources
• This position is responsible for providing entry level analytical support in the healthcare insurance reimbursement department that is responsible for managing hospital, physician and other healthcare provider contracts governing billing and payments
• This position is responsible for providing entry to intermediate level analytical support in the healthcare insurance reimbursement department that is responsible for managing hospital, physician and other healthcare provider contracts governing billing and payments. Assists with the development, implementation, oversight, analysis and reporting of assigned reimbursement contracts including related billing, payment, and utilization of health services. Works with senior staff to design system changes, training documentation, and guidelines needed to support contractual billing, claim payments and analysis. Provides ad hoc analysis and statistical reports. Designated staff may focus primarily on supporting the Medicare Advantage line of business
• Independently research, analyzes, develops and maintains new and existing, complex reimbursement programs. Designs system specifications that support claims payment and criteria for data bases that support analysis as well as training documentation describing programming, billing and payment guidelines for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business

Requirements:

• Applicants must be authorized to work for Louisiana Blue in the United States without employer-sponsored immigration support. Louisiana Blue will not provide current or future employment-based immigration sponsorship or other immigration support for this opportunity, including H-1B, L-1, O-1, H-1B1, E-3, TN, or J-1 sponsorship or F-1 OPT/STEM OPT/CPT support. Applicants who would require such sponsorship or employer support during their employment should not pursue this opportunity
• Bachelor's degree in statistics, accounting, finance, mathematics, health informatics or related field is required
• Excellent analytical, oral and written communication, and report preparation skills with the highest degree of accuracy are required
• Proficiency with Microsoft Excel including Pivot Tables and experience with either Microsoft Access or SQL Server for building queries and statistical reports required
• 2+ years of professional financial experience, reimbursement, or analysis experience required
• 4+ years of experience in the health industry accounting functions including billing, coding, Medicare or statistical analysis of financial information is required
• Excellent attention to detail, research, and documentation skills are required
• Residency in or relocation to Louisiana is preferred for all positions
• Experience with medical coding, interpreting, explaining, summarizing and making recommendations based upon research and statistical analysis is preferred
• Provider contract analysis and/or reimbursement program implementation experience is strongly preferred