Reimbursement Analyst

To support healthcare payment accuracy initiatives, the full-time remote Healthcare Reimbursement Analyst will analyze healthcare claims to identify overpayments and collaborate with various teams to recover funds while maintaining accurate documentation. Key responsibilities Analyze healthcare claims using reimbursement policies and regulations to identify overpayment opportunities Review paid claims and member eligibility data to uncover overpayment trends and potential audit opportunities Collaborate with internal teams to validate and recover overpaid claims while recommending process enhancements Required qualifications High school diploma or GED required; bachelor's degree preferred 4-6 years of healthcare reimbursement experience, including claims analysis and auditing Demonstrated knowledge of healthcare claims processing, including ICD-9-CM, HCPCS, and CPT codes Experience in healthcare auditing and validating claims data accuracy preferred Familiarity with CMS regulations and coding guidelines as they apply to healthcare claims data