200+ applicants
Health New England · 2 days ago
Senior Health Insurance Reimbursement Analyst
Springfield, Massachusetts Metropolitan Area
Full-time
Remote
Senior Level
5+ years exp
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Responsibilities
Supports the development and maintenance of tools for provider reimbursement analysis
Assists in implementing vendor software for repricing claims using CMS reimbursement methodologies
Creates and supports competitive positioning and benchmarking analysis
Manages and enhances large technical financial and statistical databases
Analyzes and improves contracting value through identification and recommendations
Verifies and analyzes rate calculations submitted by providers for accuracy
Stays abreast of reimbursement principals, governmental regulations, and requirements
Responsible for timely completion of external cost studies and financial analysis filings
Performs ad-hoc analysis and other job-related duties as required
Qualification
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Required
A Bachelor’s degree (MBA is preferred) in Finance, Accounting, Mathematics, Statistics, Actuarial, Data Science or related field.
Minimum of 5-7 years of progressive work experience in a health care analytics department setting (Healthcare Decision Support in managed care or hospital setting preferred)
Advanced technical skills with minimum of three years writing new SQL/SAS scripts and running existing scripts (Required)
Ability to recognize opportunities for innovation in reporting and work product
Ability to multi-task when faced with competing deadlines
Advanced Excel (pivot tables, V Lookups, macros etc.)
Displays positive customer focus and able to work independently with deadline orientation
Excellent analytical skills driven by a powerful inquisitiveness and curiosity about data
Experience with database and large data set usage; including reporting, management and manipulation for analytical purposes
Knowledge of healthcare financial analysis, trending, projections and analytic software models
Participates in continual learning related to CMS and Commercial reimbursement methodologies
Preferred
A Bachelor’s degree (MBA is preferred) in Finance, Accounting, Mathematics, Statistics, Actuarial, Data Science or related field.
Advanced technical skills with minimum of three years writing new SQL/SAS scripts and running existing scripts (Required)
Ability to recognize opportunities for innovation in reporting and work product
Ability to multi-task when faced with competing deadlines
Advanced Excel (pivot tables, V Lookups, macros etc.)
Displays positive customer focus and able to work independently with deadline orientation
Excellent analytical skills driven by a powerful inquisitiveness and curiosity about data
Experience with database and large data set usage; including reporting, management and manipulation for analytical purposes
Knowledge of healthcare financial analysis, trending, projections and analytic software models
Participates in continual learning related to CMS and Commercial reimbursement methodologies
Proficiency with innovating and developing new tools for end user’s needs
Company
Health New England
Health New England is a non-profit health plan serving the commercial, medicaid and medicare markets.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
unknown2024-02-15Acquired· by Point32Health
Leadership Team
Richard Swift
President & CEO
Recent News
2024-04-10
The Business Journals
2024-04-10
The Boston Globe
2024-04-10
Company data provided by crunchbase
