Senior Healthcare Data Analyst (Reimbursement) at Blue Cross and Blue Shield of LouisianaBaton Rouge, Louisiana, United States — full-time

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE

Independently researches, analyzes, develops and maintains new and existing, complex reimbursement programs. Designs system specifications that support claims payment and criteria for data bases that support analysis as well as training documentation describing programming, billing and payment guidelines for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business.

NATURE AND SCOPE

This role does not manage people

This role reports to this job: MANAGER, PROVIDER REIMBURSEMENT

Necessary Contacts: In order to effectively fulfill this position the incumbent must be in contact with:

All levels of internal personnel, with primary contacts in Network Administration, IT, Medical Management, Benefits Administration, Actuarial, Legal, Executive, Marketing, and Underwriting. Providers, provider representatives, consultants, provider specialty organizations, AMA, vendor reps, and hospital administrators to exchange or review program information. Other data sources are market research consultants, AMA, St. Anthony, Relative Value Studies for Dentists, Dun and Bradstreet and HIAA, CMS, Blue Cross and Blue Shield Association, Blue Cross and Blue Shield Plans, CMS, DHS, sales and marketing regional offices.

QUALIFICATIONS

Education

Bachelor's degree in statistics, accounting, finance, math or related field is required
Prefer a Master's Degree or pursuit of a Master's degree in Business, Information System and Decision Sciences, Healthcare Administration or Public Health.
Four years of related experience can be used in lieu of a Bachelor’s degree.

Work Experience

4 years of experience in the health industry accounting functions including billing, coding, Medicare or statistical analysis of financial information is required
Provider contract analysis and/or reimbursement program implementation experience is strongly is preferred

Skills and Abilities

Must have acquired sufficient knowledge to function autonomously and to know the appropriate contacts within departments to resolve specific issues for all lines of business.
Excellent analytical, oral and written communication, and report preparation skills with highest degree of accuracy are required. Must have the ability to ef