A reimbursement analyst works at a medical facility and is responsible for processing and recording patient information in order to accurately determine the reimbursement amount for which he/she is eligible. Those in this position also ensure that reimbursement procedures adhere to regulations and payers' operating procedures. As such, the main responsibilities of this position revolve around assisting patients in the reimbursement process while researching payer policies; each payer has a different set of regulations the analyst must follow in order to complete the jobs efficiently.
Analysis of reimbursement data is essential to minimize denials and maximize reimbursements. Therefore, reimbursement analysts work closely with both physicians and patients, as well as other employees in the department. Complex accounting functions will require specialized knowledge, so a Bachelor's degree in Accounting or a related field is highly recommended.
Reimbursement analysts also analyze workloads, determine priorities, assign duties, and oversee work progress in reimbursement-related matters, such as in preparing internal and cost reports. Compliance with regulations is a very important aspect of the job, and confidentiality is a must. Regular work hours and a fixed schedule can be expected, along with sick days and paid holiday time. Travel is generally not required.
Reimbursement Analyst Tasks
Prepare insurance annual cost reports.
Maintain relationship with hospital or health services management and work to resolve reimbursement issues.
Prepare journal entries, various financial or statistical analyses, reconciliation's, or research activities.
Prepare quarterly progressions which involves reconciliation of third party receivables/payables and analysis of reserves.
Coordinate resolution of intermediary and state agency audit requests, including obtaining audit documentation from other departments and communicating status to supervisor.