Healthcare Reimbursement Analyst

Join the GBS RevCycle- Odyssey Health Systems Team and be a valuable member in the world of medical billing!

At GBS RevCycle, we're transforming healthcare with our comprehensive Revenue Cycle Management (RCM) solution.

Location: Onsite in Fairlawn, OH with hybrid work model potential following 90 days

Full-Time Benefits: We care about your well-being. Our benefits include Medical, Dental, Vision, Accident, Disability Insurance, PTO, Holidays, Wellness plans, Profit Sharing, 401(k), and more.

Are You Ready for an Exciting Medical Billing Career?

GBS RevCycle is at the forefront of the industry, and we're growing rapidly. Join us if you're motivated, ambitious, and ready to make a difference!

POSITION SUMMARY

We are seeking a highly motivated and analytical individual with a background in Revenue Cycle Management (RCM) to join our growing team as a Healthcare Reimbursement Analyst. Candidates should possess an understanding of healthcare revenue cycle and government and commercial payer reimbursement processes. This role requires strong analytical skills, attention to detail, and the ability to work with large data sets to identify payer reimbursement issues and trends.

The role requires analyzing financial data to identify areas to drill down and developing financial reports from billing system data for follow up actions by internal and client teams, to ensure accurate and timely reimbursement for healthcare services. The role will also develop operational reporting on backlogs, productivity and other internal performance metrics.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Generate reports and dashboards related to reimbursement activities, including reimbursement trends, payer performance, and revenue cycle metrics. Prepare comprehensive reports for internal and external stakeholders.
• Conduct detailed analysis of healthcare reimbursement data, including claims, payments, denials, and adjustments, to identify root causes of trends and discrepancies from expected reimbursement.
• Collaborate with management, revenue cycle team and client, by providing data and reports and identifying trends to optimize revenue cycle processes, streamline workflows, and maximize reimbursement. Identify opportunities for revenue enhancement and cost reduction.
• Generate weekly / monthly backlog and AR-related reports across revenue cycle functions, to include AR credit balances, AR adjustments and write-offs, denial and appeal success rates by physician, code, payer, denial reason, claims pending submission, claim rejections, claims in coding review and medical record requests.
• Develop financial dashboards to monitor monthly revenue cycle performance, that include metrics on accounts receivable, AR aging, credit balances, charge volume and collections, denials and appeals, days revenue in AR, payer-specific data and metrics, and other relevant data.
• Compile and report internal productivity data weekly for management review and used as a tool for team leaders to improve processes and performance. Develop reporting to communicate team and individual productivity over time. Troubleshoot data issues to ensure the accuracy of data reported.
• Identify opportunities for process improvement and automation within the reimbursement and revenue cycle management functions. Participate in implementation initiatives to enhance efficiency, accuracy, and productivity.
• May undertake other special projects assigned by management related to reimbursement or process improvements.

QUALIFICATIONS (Knowledge, Skills, and Ability Requirements)

• Bachelor's degree in Healthcare Administration, Finance, Accounting, Business, or related field.
• Minimum of 3 years of experience in an analytic role, preferably in healthcare reimbursement analysis or revenue cycle management.
• Knowledge of healthcare reimbursement processes and methodologies, including Medicare, Medicaid, and commercial payers.
• Basic understanding of healthcare coding systems (e.g., ICD-10, CPT, HCPCS) and coding guidelines.
• Strong analytical skills with the ability to interpret complex reimbursement data and identify trends and patterns.
• Excellent communication and interpersonal skills with the ability to collaborate effectively with internal teams and external stakeholders.
• Detail-oriented with a high level of accuracy and precision in data analysis and documentation.
• Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
• High proficiency in data extraction and manipulation, Microsoft Excel and reporting tools.

ENVIRONMENTAL/WORKING CONDITIONS

• Normal office environment
• Sit for long periods of time; manual dexterity, use a calculator and to operate a computer keyboard; frequent mobility required to access files; bending, stooping, walking and lifting required
• Must be able to work flexible hours, when necessary, with occasional extended hours when necessary
• Occasional overtime, typically at month-end

SUPERVISORY RESPONSIBILITIES

• Does this job have supervisory responsibilities? No
• Are there subordinate supervisors reporting to this job? No
• Are there other non-supervisory employees who report directly to this job? No

GBS RevCycle/Odyssey Health Systems is an equal opportunity and affirmative action employer. We consider all qualified applicants for employment without regard to race, color, religion, creed, national origin, sex, pregnancy, age, sexual orientation, transgender status, gender identity, disability, alienage or citizenship status, marital status or partnership status, genetic information, veteran status or any other characteristic protected under applicable law.