Institutional Reimbursement Administrator-Jobs in Nebraska
Description
Job Description:
Reimbursement Administrator
Major Job Function
This position is a key strategic partner to health network reimbursement and will be directly involved in structuring reimbursement for institutional and professional networks. In this role, they will support the initiatives of the institutional reimbursement team.
Essential Job Functions
Evaluate rate proposals for institutional providers to determine trend, medical cost, and pricing impact
Accurately construct and maintain reimbursement schedules.
Assist in data and claims analysis to prepare reports in support of network performance evaluation, product development & network strategy.
Serve as a subject matter expert to health network services, account teams, consultants and brokers regarding network reimbursement.
Assist with analysis of reimbursement proposals for new and existing contracts.
Provide advice/guidance/recommendations to senior management regarding health care costs; cost savings opportunities; best practices; provider performance issues; and network expansion.
Participate in activities related to claims system renewal and network configuration
Knowledge Skills and Abilities
The demonstrated ability to relate analytic findings to business questions and objectives.
A strong understanding of the health care industry, professional and facility reimbursements and billing practices.
The demonstrated ability to work effectively within a team environment – showing respect and consideration for diverse viewpoints.
Ability to utilize knowledge and history to predict outcomes of potential and proposed contracting decision scenarios.
Excellent written and oral communication skills.
Education Training and Experience
BA or BS in Mathematics, Finance, Accounting, Economics, Healthcare or other business related field.
A minimum of 3 years direct support and participation in health network contracting and administration with facilities and professionals.
A strong understanding of professional and institutional reimbursement methodologies
https://www2.recruitingcenter.net/Clients/bcbsne/PublicJobs/controller.cfm?jbaction=JobProfile&Job_Id=10464
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