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Job Description
- We’re northern Michigan’s largest healthcare system and we are deeply rooted in the communities we serve. That means that our patients are often our family, friends and neighbors – and it’s special to be able to care for them. And as one of the top healthcare systems to work for in Michigan by Forbes (American’s Best Employers by State 2022), we’re committed to your ongoing growth and development.
- After work, you’ll find things to do in every season – beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment.
Summary:
Review hospital system reimbursement for insurance overpayment or underpayment. Submit appeals to insurance payors. Set up and maintain insurance contract information in reimbursement management system. Maintain and verify all facility and or professional insurance contracts.
Specific Duties:
- Uses effective customer service/interpersonal skills at all times.
- Evaluates billing, coverage and reimbursement changes for all payers and supports management in educating staff in the development of new policies and procedures affected by these changes.
- Collaborates with Revenue Cycle departments to resolve insurance rejections, denials, and appeals. Participates in monthly Revenue Cycle rejection and denials improvement meetings.
- Produces monthly reports for Revenue Cycle management and various service line managers.
- Provides education to individual service line management and staff regarding reimbursement, denials, and appeals.
- Maintain and build payor rules in reimbursement system, with periodic system testing to ensure accuracy.
- Performs third party payer appeals based on knowledge of rules and regulations, and Munson Healthcare policies and procedures.
- Supports Contract Management in the review, development, and implementation of insurance contract terms. Builds and maintains contract database for all system payor agreements including providing this data to third party vendors for price estimations.
- Identifies reimbursement variances and patterns and works with third party payers, contract managers and Revenue Cycle staff to resolve variances.
- Provides billing and reimbursement information, and reviews for various departmental managers upon request.
- Performs other duties and responsibilities as assigned.
Why work as a Reimbursement Analyst at Munson Healthcare?
- Remote work schedule
- Our dynamic work environment includes many opportunities for growth and development
- Be a part of a team that nurtures a culture of caring every day
- Our employees work in positive, supportive, and compassionate environments built on our organizational values.
What’s Required:
- Bachelor’s Degree in Business Administration or related field, or the equivalent combination of education and/or experience required.
- Five years analytical and financial experience in the healthcare setting, with demonstrated ability of problem-solving. Must be able to prioritize workload on a daily basis.
- Extensive knowledge of all medical insurances, third party payer rules, regulations, coding, and reimbursement guidelines, along with hospital Revenue Cycle policies and procedures, is needed.
- Must possess strong analytical and interpretive skills, with a propensity for thoroughness and attention to detail. Must be able to prepare and present analyses and reports and formulate recommendations and participate in Revenue Cycle process improvement development in a compliant manner based on the analysis.
The Benefits of Working at Munson:
- Competitive salaries
- Full benefits, paid holidays, and paid time off (up to 19 days your first year)
- Tuition reimbursement and ongoing educational opportunities
- Retirement savings plan with employer match and personal consulting
- Wellness plans, an employee assistance program and employee discounts
*Terms and conditions apply
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