At Boston Children's Hospital, the quality of our care - and our inclusive hospital working environment - lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices are heard and ideas are shared. Join us, and discover how your unique contributions can change lives. Yours included.
This Case Mix/Reimbursement Analyst II in the Physician Organization (PO) will be responsible for:
Gathering data to perform detailed analyses of Commercial, Managed MCD/MCO and National plans contract analyses.
Performing payor detail account transaction activity, reviewing insurance payment accuracy, inappropriate payors deviations, interpreting trends and making recommendations for corrective action.
Analyzing data to identify trends both related to systematic configuration and payor issues to improve department operations.
Creating reports within EPIC and Contract Manager, summarizing data and its findings in an effective manner.
Communicating reports to key department stakeholders and leverage the reports' insights to drive Reimbursement improvement projects.
Working towards improving and identifying build or system configuration rules that impact the proper value of underpaid claims or reimbursement
Working with improvement project team to understand and assist with tracking of key initiatives, metrics, and project assignments.
To qualify you must have:
A Bachelor's Degree with a concentration in Accounting or a closely related field and 2+ years related experience
Proficiency with MS Office applications, in particular Excel and Access
Please note: During a public health emergency, individuals in this role may be expected to take on additional duties to respond to organizational needs.
Boston Children's Hospital offers competitive compensation and unmatched benefits, including an affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, cell phone plan discounts and discounted rates on T-passes (50% off). Discover your best.
Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
Internal Number: 3108531
About Boston Children's Hospital
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.