Louisiana Blue · 1 week ago
Senior Healthcare Data Analyst (Reimbursement)
Baton Rouge, LA
Full-time
Onsite
Mid, Senior Level
4+ years expLouisiana Blue is dedicated to improving the health and lives of Louisianians, and they are seeking a Senior Healthcare Data Analyst to independently research and analyze complex reimbursement programs. The role involves designing system specifications for claims payment and maintaining databases to support analysis and training documentation.
Health CareInsuranceNon Profit
Responsibilities
Independently researches, analyzes, develops and maintains new and existing, complex reimbursement programs
Designs system specifications that support claims payment and criteria for data bases that support analysis as well as training documentation describing programming, billing and payment guidelines for internal and external use
Identifies claims and provider reimbursement related system problems, including claims coding and processing issues, coordinates research, audit, and recommendations with Provider Audit, and implements and monitors system changes to resolve any problems
Researches, designs, implements, and maintains complex hospital or professional provider reimbursement programs for traditional and managed care programs and Medicare Advantage
Leads in the development of complex financial pricing models and financial data analysis to support modifications to reimbursement programs and monitor effectiveness of pricing logic
Provides statistical reports to Network Administration, Medical Management, Marketing and Medicare Advantage to support internal strategies and external customer needs, such as contract negotiations and marketing efforts
Complies with Corporate Objectives on project implementation and schedule deadlines
Ensures proper workflow by assessing reimbursement processes and recommending improvement as well as coordinating projects and time frames with less senior reimbursement staff
Accountable for complying with all laws and regulations associated with duties and responsibilities
Serves as provider reimbursement technical advisor and/or committee participant to Information Technology staff, Benefits Administration staff, Provider Audit, Network Administration and/or Medicare Advantage staff, and entry level Reimbursement Analyst by developing and implementing project/program narratives and responding to concerns on new and existing reimbursement programs, billing guidelines, and system requirements to ensure accurate implementation and maintenance of provider reimbursement programs
Qualification
Required
Bachelor's degree in statistics, accounting, finance, math or related field is required
4 years of experience in the health industry accounting functions including billing, coding, Medicare or statistical analysis of financial information is required
Excellent analytical, oral and written communication, and report preparation skills with highest degree of accuracy are required
Requires strong math/analytical skills including variance analysis, statistical formulas, algebraic formulas, percentages, multiplication and division, fractions and reasonableness tests
Excellent attention to detail, research, and documentation skills are required
Proficiency with commonly used database, spreadsheet and word processing software is required
Must have extensive knowledge to select the appropriate database format and structure for the type of information to be captured and reported
Minimal travel is required
Accountable for complying with all laws and regulations associated with duties and responsibilities
Preferred
Prefer a Master's Degree or pursuit of a Master's degree in Business, Information System and Decision Sciences, Healthcare Administration or Public Health
Provider contract analysis and/or reimbursement program implementation experience is strongly preferred
Familiarity with relational database software, mainframe capabilities, FOCUS and SQL programming is helpful and preferred
A strong understanding of physician charge practices and billing methodologies is helpful
Pursuit of coding (CPC or CPHC) designation is preferred
Company
Louisiana Blue
Louisiana Blue is a company on a mission: to improve the health and lives of Louisianians.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Crystal Blanchard
Account Executive
Recent News
New Orleans CityBusiness
2025-09-19
Company data provided by crunchbase