Reimbursement Analyst 2

Additional Links:

This position is Benefit eligible; click here for an overview of available benefits.
This position is covered by the UHP Bargaining Unit; click here to review the current UHP Contract.
This position is in salary group UHP-11; click here to review the current UHP Pay Plan.

Supporting Patient Estimates at UConn Health, this position is responsible for independently performing a full range of complex tasks and project management in reimbursement analysis, including development of procedures to ensure recovery of all inpatient and outpatient charges, contract management, external financial reporting, revenue capture, accounts receivables analysis, and regulatory compliance monitoring.

Supervision Received

Works under the limited supervision of an employee of higher grade.

Supervision Exercised:

May Lead/supervise staff as assigned.

Examples of Duties:

• Coordinates projects such as Medicare cost reporting;

• Meets with senior managers to discuss reimbursement issues;

• Prepares and presents data to senior management;

• Deals directly with payers to resolve transactional issues if necessary;

• Resource to members of the university community regarding reimbursement issues;

• Provides training as required;

• Develops techniques for effective analyses of reimbursement trends;

• Reviews, analyzes and interprets insurance payments and denials to ensure proper payment;

• Works with billing supervisors to modify billings to meet contract specifics, as well as charge-master analyst;

• Recommends updates to charge-master; develops and maintains system for tracking and evaluating performance of insurance carrier to maximize reimbursement and ensure billing compliance with audit standards;

• Provides reimbursement patterns and trends to the management;

• Prepares reports and analyses to include financial reports, setting forth progress, adverse trends and appropriate recommendations and conclusions;

• Submits external reports and handles all edits and changes required by meeting with appropriate departments to obtain correct data;

• Monitors and evaluates current reimbursement rules and changes that impact revenue capture and communicates this information to the clinical faculty, staff, and billing personnel;

• Provides in-service training for finance personnel;

• Develops and recommends policies and procedures;

• Schedules assigns, oversees and reviews work of assigned staff; applies personnel policies and procedures;

• Prepares or assist in the preparation of the department budget subject to administrative review;

• Acts as liaison with other operating units, agencies and outside officials regarding third party reimbursements;

• Prepares profit and loss statements;

• Performs other related duties.

Minimum Qualification Required:

Knowledge, Skill and Ability:

• Considerable knowledge of the principles and practices of financial management;

• Knowledge of the healthcare reimbursement;

• Knowledge and ability to apply relevant Federal and State laws, statutes and regulations;

• Knowledge of statistical methodologies;

• Considerable interpersonal skills, oral and written communication skills;

• Considerable knowledge of insurance billings and collection procedures including CPT and ICD coding;

• Advanced spreadsheet and computer skills;

• Advanced analytical skills;

• Considerable ability in the interpretation and analysis of complex financial, statistical and technical data;

• Supervisory ability.

Preferred Qualifications:

• Experience with the Epic Estimates module

• Strong familiarity with the No Surprises Act

• Knowledge of insurance plan benefits

• Strong understanding of payer contracts and reimbursement methodologies

Education and Training:

General Experience:

Eight (8) years experience related to revenue capture, healthcare reimbursement procedures, including working knowledge of CPT and ICD-9 codes. Four (4) years of the experience must be in a healthcare environment.

Substitution Allowed: Bachelor's degree in financial management, accounting, healthcare administration or closely related field may be substituted for four (4) years of the experience.

SCHEDULE: Full-time, Monday-Friday, 8:00am-4:30pm.

Why UConn Health

UConn Health is a vibrant, integrated academic medical center that is entering an era of unprecedented growth in all three areas of its mission: academics, research, and clinical care. A commitment to human health and well-being has been of utmost importance to UConn Health since the founding of the University of Connecticut schools of Medicine and Dental Medicine in 1961. Based on a strong foundation of groundbreaking research, first-rate education, and quality clinical care, we have expanded our medical missions over the decades. In just over 50 years, UConn Health has evolved to encompass more research endeavors, to provide more ways to access our superior care, and to innovate both practical medicine and our methods of educating the practitioners of tomorrow.