Sr. Medicare; PPS Provider Hospital Reimbursement Analyst

Why consider this job opportunity:

• Salary up to $121,400 per year
• Eligible for a bonus incentive plan based on company and individual performance
• Comprehensive benefits including medical, dental, vision, and 401(k) retirement savings plan
• Generous paid time off, including volunteer time off and paid parental leave
• Opportunity for career advancement and growth within the organization
• Work remotely with occasional travel to the employer's offices for training or meetings

• Research and maintain expertise in Medicare Outpatient Prospective Payment System reimbursement methodologies
• Analyze and interpret CMS Regulatory documentation for Medicare Prospective Payment Systems
• Support implementation of Medicare pricer projects and enhancements including reviewing vendor specifications
• Conduct ongoing Medicare Pricer maintenance, quality assurance, and compliance
• Provide consultation to internal business partners on Medicare reimbursement/editing logic

• Strong understanding of Medicare reimbursement methodologies
• Minimum of 3 years of experience in healthcare reimbursement or related field
• Proficient in analyzing regulatory documentation and pricing software
• Exceptional problem-solving skills to determine root causes and develop solutions
• Ability to work independently in a home office environment with required internet speed

• Experience working with Integrated Outpatient Code Editor (I/OCE) logic
• Familiarity with data automation and improvement opportunities
• Prior experience in a remote work setting
• Knowledge of HIPAA regulations and compliance
• Excellent communication skills for collaboration with cross-functional teams

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