Logo for Health Care Service Corporation

Reimbursement Analyst I - Work From Home

Role overview

Qualifications

  • Bachelor Degree in Business Administration or Computer Science with 3 years' experience in data analysis and reimbursement OR 7 years' experience to include data analysis, reimbursement analysis/modeling, and college courses
  • Experience and basic understanding of reimbursement methods and financial modeling
  • Health Care data experience and knowledge of Medicare pricing methodologies (RBRVS, DRG, ASC)
  • Verbal and written communication skills as well as interpersonal skills necessary to work in a team environment

Responsibilities

  • Develop reports based on a number of internal/external databases using common programming languages
  • Create pricing models for network negotiations and fee schedule updates used for claims adjudication
  • Implement pricing information into the PREMIER Pricer system
  • Validate and research report results using original operation systems and reporting databases

Key facts

Hard skills

Other skills

  • Microsoft Office
  • Communication
  • Social Skills
  • Analytical Skills

About the company

Health Care Service Corporation logo

Health Care Service Corporation

Health Insurance (Payers)

Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is an Independent Licensee of the Blue Cross and Blue Shield Association. We are the largest customer-owned health insurer in the United States, serving more than 18.6 million members through our Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. For nearly a century, we have enabled and coordinated the access to quality care for millions of members. Our experience and industry knowledge establishes a solid foundation for our future—driving innovations that further expand access, improve health outcomes, and reduce costs. Embedded within the fabric of how we operate is a deep sense of caring and commitment that informs how we serve our members, engage in local communities, and deliver positive change to the health care industry. As health care needs evolve, we leverage our portfolio of companies to deliver differentiated value to all industry stakeholders so that, together, we make more possible. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization: HCSC.com/careers. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to an inclusive, drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability, or protected veteran status.

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

SUMMARY:
This position is responsible for developing reports based on a number of internal/external databases using common programming languages. This person will create pricing models for network negotiations and fee schedule updates used for claims adjudication and implement pricing information into the PREMIER Pricer system. Will also be responsible for validating and researching report results using the original operation systems and reporting databases as well as presenting reports to internal/external customers and responding to follow-up questions.

Required Job Qualifications:  

  • Bachelor Degree in Business Administration or Computer Science with 3 years' experience in data analysis and reimbursement OR 7 years' experience to include data analysis, reimbursement analysis/modeling, and college courses.
  • Experience and basic understanding of reimbursement methods and financial modeling.
  • Health Care data experience and knowledge of Medicare pricing methodologies (RBRVS, DRG, ASC).
  • Verbal and written communication skills as well as interpersonal skills necessary to work in a team environment.
  • Analytical skills.
  • Self-starter with ability to work with minimal supervision to meet deadlines.
  • PC proficiency to include MS Office or other spreadsheet and word processing software for Windows

Preferred Job Qualifications: 

  • Technical background in BASIC programming languages.
  • 1 year experience or more in FACETS or other Reimbursement Systems.
  • 1 year experience with Provider contract (operations, fee schedules, rate sheets, contract lifecycle support, etc.)
  • 1 year healthcare claims adjudication experience.

Sponsorship will not be provided for this role.

This is a Telecommute (Remote) role.

#LI-LI1

#LI-Remote

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.  Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$55,900.00 - $123,500.00

Exact compensation may vary based on skills, experience, and location.

Apply once. Then go straight to the hiring manager.

After you apply, unlock the direct contact details of the people who actually make the call. A quick follow-up makes you 5x more likely to land an interview.

MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
Unlocked after you apply
·

Payments Analyst Related jobs

Other jobs at Health Care Service Corporation

Premium

Reach out to the hiring manager directly.

Gain access to the contact details of the hiring managers who actually decide, and reach out to network with them directly. That, plus more when you upgrade:

  • Full match report with fit score and gaps
  • Career diagnostics on how recruiters read you
  • Curated company matches and warm intros
  • 48h early access to new roles

Cancel anytime.