Senior Business Intelligence Engineer - Medicare Provider Hospital Reimbursement - Remote

Overview

The Medicare (PPS) Provider Hospital Reimbursement Analyst, also known as a Senior Business Intelligence Engineer, will be an integral part of the Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies.

In Short

• Researching and maintaining expertise in Medicare Outpatient Prospective Payment System reimbursement methodologies.
• Demonstrating expertise in Medicare Integrated Outpatient Code Editor logic.
• Analyzing and interpreting CMS Regulatory documentation for Medicare Prospective Payment Systems.
• Supporting implementation of Medicare pricer projects and enhancements.
• Identifying system changes needed to accommodate CMS logic.
• Creating and executing comprehensive test plans.
• Determining root causes driving issues and developing solutions.
• Research and resolve complex provider reimbursement inquiries.
• Providing consultation to internal business partners on Medicare reimbursement logic.
• Utilizing data and expertise to identify automation and improvement opportunities.

Requirements

• Experience in Business Intelligence and Data Analysis.
• Strong understanding of Medicare reimbursement methodologies.
• Proficiency in analyzing regulatory documentation.
• Ability to work collaboratively with IT and other business teams.
• Experience in quality assurance and compliance.
• Strong problem-solving skills.
• Excellent communication skills.
• Ability to work independently in a remote environment.
• Familiarity with project management principles.
• Proficient in using data analysis tools.

Benefits

• Competitive medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, including personal holidays and volunteer time off.
• Short-term and long-term disability coverage.
• Life insurance and other opportunities for personal wellness.
• Bonus incentive plan based on performance.
• Support for work-life balance.
• Access to comprehensive health resources.
• Opportunity for professional development and training.
• Inclusive workplace culture.