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Luminis Health · 1 week ago

Senior Reimbursement Analyst

Annapolis, MD

Full-time

Onsite

Mid, Senior Level

$80K/yr - $105K/yr

Luminis Health is a healthcare organization seeking a Senior Reimbursement Analyst to analyze and prepare healthcare reimbursement data. This role involves ensuring compliance with regulatory reporting requirements and leveraging data analytics to optimize reimbursement strategies while providing financial insights for organizational decision-making.

Health CareMedicalNon Profit

Responsibilities

Prepares and reviews monthly, quarterly, and annual revenue and statistical reports for accuracy, reasonableness, completeness and distributes them to appropriate management. Including, but not limited to, monthly and quarterly HSCRC reports/reconciliations, HSCRC Annual Filing and Medicare Cost Reports

Responsible for HSCRC Case Mix data submissions and corresponding error resolution with various departments such as registration, revenue integrity, billing, and IT. This includes active participation in HSCRC data forum workgroups to ensure regulatory reporting compliance

Monitors volume and charge information to ensure unit rate and GBR compliance, making recommendations and facilitating necessary price changes

Develops/maintains analytical models to identify opportunities for reimbursement maximization to guide financial decision making across hospital operations

Assists in responding to internal and external requests for information and special projects (ex: establishment of rates for new services, GBR modification requests, performance improvement initiatives, etc.)

Actively participates in discussions and analysis related to quality-based reimbursement opportunities (RRIP, MHACs, QBR, etc.) and other value-based or population health reimbursement opportunities