Payer Reimbursement Analyst

This is a hybrid opportunity. The ideal candidate must be commutable to one of our facilities Nationwide.

The Payer Reimbursement Analyst is charged with creating analytical reports to generate effective forecasting and predictive modeling of payer negotiations and anticipated revenue impacts. Will use critical thinking, analytical skills and appropriate decision making to analyze accounts and trends, using that feedback to model rates and forecast impact of the negotiation process. This position will interpret payment and denial data down to the line item detail, identify payer and coding trends, risks, and identify key recommendations and impacts of our health plan negotiation process.

Essential to this position are strong quantitative, analytical and organizational skills. Excellent communication and interpersonal skills with the ability to effectively interpret, communicate, and educate others.

• Analyze billing practices, denial reasons, and payer reimbursement to identify and share payment related issues prior to negotiations.

• Review volumes, trends, average length of stay, current reimbursement compared to established rates, DSO and other payer measures to ensure plan is paying according to the agreement.

• Forecast budget impact related to changes in rates. Create and use predictive modeling to ensure rate impacts are agreeable for Hazelden Betty Ford.

• Support the patient accounts team to understand trends with front end claim errors/failures, creating corrective action plans in the form of edits, workflows, etc. to reduce reoccurrence.

• Thorough knowledge of payer policies, subscriber benefits, non-covered services, coding and diagnosis issues and accounts receivable.

• Compiles, analyzes, and reports on data related to underpayments, denials, revenue opportunities and revenue leakage. With the Vice President of Payer Relations create communication plans internally and externally to improve processes and standard work to solve for these issues.

• Conduct detailed analyses of data and information relating to A/R trends and reimbursement. Summarize research findings into graphs, charts, written summaries and presentations for review by leadership and explain/interpret results upon request.

Required Qualifications:

• Bachelor's degree in business or related field or Associate's degree plus 4 yrs. directly related work experience
• Minimum 4 yrs. experience in the healthcare industry
• Proficient in: Excel, Power BI, Cerner and/or Fin Thrive
• Knowledge and understanding of revenue analytics, contract analytics and payment modeling
• Ability to learn and adapt quickly to new healthcare technology systems, processes, and procedures to ensure a working knowledge to be able to effectively provide quality analysis.
• Strong written and oral communication skills

Preferred Qualifications:

• Bachelor's degree in business, healthcare, or analytics.
• Experience in a hospital or behavioral health business office dealing with patient billing or patient accounting.
• Working knowledge: Microsoft Visio, and Adobe
• Experience presenting complex models to executive leaders

The Hazelden Betty Ford Foundation is the largest nonprofit addiction recovery organization in the United States. It is also one of the most mission-driven places you will find. The Hazelden Betty Ford Foundation team is passionate about providing hope and ultimately healing. As a living, growing and evolving institution, the Hazelden Betty Ford Foundation is - at our core- a people-powered organization. Hazelden Betty Ford Foundation is comprised of 1600+ employees, seventeen treatment sites and produces $190 million dollars in annual revenue. This exemplary organization serves nearly 25,000 people annually and is committed to provide hope and healing for those experiencing addiction to alcohol and other drugs.

What makes this organization unique is its total ecosystem approach to prevention, education, research, advocacy and treatment. All of the parts of the organization work together to inform, develop and deliver evidence- based practices that help people reclaim their futures and restore their hope.

Being "a best place to work" is a strategic goal of Hazelden Betty Ford Foundation and it's a goal that every employee plays an active role in helping to achieve. Our culture is a reflection of how encouraged and energized we each feel about contributing our ideas and performing to our greatest ability. Join us and do meaningful work.

We deeply value our employees. Working at Hazelden Betty Ford Foundation includes a comprehensive benefits package, including:

• Competitive Health, Dental and Vision Plans
• Retirement savings plan with employer match
• Paid time-off
• Tuition reimbursement

The Hazelden Betty Ford Foundation is proud to be an equal opportunity and affirmative action employer. We believe that diversity and inclusion among our colleagues is critical to our success as a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs; and we seek to recruit, develop and retain the most talented people from a diverse candidate pool.