Overview

Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service.

Responsibilities

Position Summary:

The Reimbursement Analyst provides direct support to the Manager of the Revenue Integrity department, as well as other business partners. This position includes, but is not limited to, performing retrospective review of medical claims payments, reviewing and interpreting negotiated payer contracts at a general level, as well as understanding how it translates into changes within the current contract management system. This position includes updating contracts in the contract management system; identifying valid underpayments and generating appeals in an attempt to recover on underpaid medical claims. This position is also responsible for identifying areas of overpayments; is expected to communicate with payers in an attempt to stop the erroneous overpayments and work with the refund department to issue any necessary refunds once the issue is resolved.

Qualifications

Minimum Qualifications:

3 years experience working in healthcare revenue cycleHigh School Diploma/GEDExcellent communication skillsExperience in the use Microsoft ExcelGECB knowledge

Preferred Qualifications:

Minimum of 5 years revenue cycle experience as well as experience in reviewing and interpreting contractsDemonstrated analytics skillsIntermediate experience in Microsoft ExcelExperience in the Experian Contract Management tool