Senior Reimbursement Analyst-Faculty Group Practice
NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's hospital, three emergency rooms and a level 1 trauma center. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute designated comprehensive cancer center, and NYU Grossman School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. At NYU Langone Health, equity, diversity, and inclusion are fundamental values. We strive to be a place where our exceptionally talented faculty, staff, and students of all identities can thrive. We embrace diversity, inclusion, and individual skills, ideas, and knowledge. For more information, go to nyulangone.org , a nd interact with us on LinkedIn , Glassdoor , Indeed , __Facebook , Twitter , YouTube and Instagram .
Position Summary:
We have an exciting opportunity to join our team as a Sr. Reimbursement Analyst.
In this role, the successful candidate will be responsible for taking a leadership role amongst the team of Reimbursement Analysts responsible for reviewing physician utilization and payment data related to managed care reimbursement. The Senior Analyst act as a team lead for those responsible for creating and analyzing contract compliance reports to measure and identify revenue opportunities from commercial payers to complement the Faculty Group Practice revenue cycle operations. The incumbent will analyze payer reimbursements to identify trends and payments inconsistent with contractual rates and terms. In the role the Senior Analyst will collaborate with their team to cohesively present and share their findings to Management for escalation. The candidate for this role will work collaboratively with Revenue Cycle and FGP Operations to contribute in the resolution of escalated issues with payers and to assist in the development of tools and educational materials for FGP front-end staff and billing staff. The position requires a fundamental understanding of professional billing, industry standard reimbursement methodologies as well as the ability to interpret and understand managed care contracts.
Job Responsibilities:
* Collaborate across departments to identify and resolve payer related issues requiring detailed research and follow-up.
* Assist in the development of training tools and work flows that contribute to enhanced productivity and staff knowledge.
* Develop a comprehensive understanding of managed care contracts between NYU School of Medicine and external commercial payers.
* Establish a leadership role on a team. Create and monitor shared goals and initiatives that team members can work collaboratively on.
* Identify denial and underpayment trends across the Faculty Group Practice by developing a deep understanding of payer policies, contract terms and industry standard reimbursement methodologies.
* Perform data mining audits to identify and recover underpayments caused by contract misinterpretation and invalid denials in order to maximize reimbursement, efficiently lower A/R, and expedite the revenue cycle process.
Additional Position Specific Responsibilities:
Prepare data files to share with external contacts at managed care payers. Ensure a detailed and comprehensive understanding of the issues and be able to Communicate verbally and via email the issues identified as well as the expected resolution and reasonable period for completion.
Work collaboratively with a variety of departments within NYU School of Medicine and externally with commercial managed care payers.
Learn appropriate new software systems to help analyze and evaluate claims data.
Work independently, take initiative, and think critically.
Minimum Qualifications:
To qualify you must have a Bachelor's degree in business or healthcare administration or related field plus a minimum of two years of experience; or an equivalent combination of education or relevant work experience. High level of analytical skills and dynamic communication skills (verbal and written) are required. Microsoft Excel and Word familiarity required.
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
If you wish to view NYU Langone Health's EEO policies, please click here. Please click here to view the Federal "EEO is the law" poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information.
NYU Langone Health provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $58,500.00 - $81,120.00 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.
To view the Pay Transparency Notice, please click here
Required Skills
Required Experience