Senior Provider Hospital Reimbursement Analyst

HumanPanorama

California, US
Base: $80,900 - $110,300 py; bonus/equity: eligibl...
Hybrid
Medicare outpatient prospective payment system
Medicare integrated outpatient code editor
Cms regulatory documentation research
The job posting is for a Senior Provider Hospital Reimbursement Analyst at Humana, focused on administering complex Medicare provider reimbursement methodologies. The role requires expertise in Medicare reimbursement systems and involves collaboration with various teams to enhance operational processes

Job Summary

  • The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies.
  • This role involves researching and maintaining expertise in Medicare Outpatient Prospective Payment System reimbursement methodologies and Integrated Outpatient Code Editor logic.
  • Humana offers competitive benefits that support whole-person well-being, including medical, dental, vision, 401(k), and various paid time off opportunities.

Matching Summary

Match Score: 85

The job posting is for a Senior Provider Hospital Reimbursement Analyst at Humana, focused on administering complex Medicare provider reimbursement methodologies. The role requires expertise in Medicare reimbursement systems and involves collaboration with various teams to enhance operational processes.

Salary

Base: $80,900 - $110,300 per year; Bonus/Equity: eligible for bonus incentive plan; Benefits: medical, dental, vision, 401(k), time off, disability, life insurance

Skills & Requirements

Must-have

  • Medicare Outpatient Prospective Payment System
  • Medicare Integrated Outpatient Code Editor
  • CMS Regulatory documentation research
  • Pricing software vendor specifications
  • Provider reimbursement inquiries resolution

Nice-to-have

  • Whole-person well-being benefits
  • Caring community environment
  • Continuous improvement opportunities

Key Requirements

  • Minimum 3 years Medicare PPS reimbursement research
  • Minimum 3 years facility claim inquiries resolution
  • Minimum 2 years Medicare I/OCE logic research
  • Minimum 1 year Optum EASYGroup software
  • Strong oral and written communication skills

Work Rights

Not specified

Tailored Resume

Cover Letter