About this role
Luminis Health
Title: Senior Reimbursement Analyst
Department: Reimbursement
Reports to: Director of Revenue Strategy & Analytics
Job Code: 003138
FLSA Status: Exempt
The Senior Reimbursement Analyst is responsible for analyzing, preparing, and reviewing healthcare reimbursement data, including cost reports, volume and revenue metrics, and revenue cycle performance. This role ensures compliance with federal and state regulatory reporting requirements, leverages data analytics to optimize reimbursement strategies, and provides financial insights to support informed organizational decision-making.
1. Prepares and reviews monthly, quarterly, and annual revenue and statistical reports for accuracy, reasonableness, completeness and distributes them to appropriate management. Including, but not limited to, monthly and quarterly HSCRC reports/reconciliations, HSCRC Annual Filing and Medicare Cost Reports.
2. Responsible for HSCRC Case Mix data submissions and corresponding error resolution with various departments such as registration, revenue integrity, billing, and IT. This includes active participation in HSCRC data forum workgroups to ensure regulatory reporting compliance.
3. Monitors volume and charge information to ensure unit rate and GBR compliance, making recommendations and facilitating necessary price changes.
4. Develops/maintains analytical models to identify opportunities for reimbursement maximization to guide financial decision making across hospital operations
5. Assists in responding to internal and external requests for information and special projects (ex: establishment of rates for new services, GBR modification requests, performance improvement initiatives, etc.)
6. Actively participates in discussions and analysis related to quality-based reimbursement opportunities (RRIP, MHACs, QBR, etc.) and other value-based or population health reimbursement opportunities.
· Bachelor's degree in Finance, Accounting, Statistics, Healthcare or related field from an accredited college or university.
· Working knowledge of financial and accounting principles
· Ability to manage multiple projects and prioritize under minimal supervision
· Strong knowledge of computer software programs
Luminis Health Benefits Overview:
• Medical, Dental, and Vision Insurance
• Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
• Paid Time Off
• Tuition Assistance Benefits
• Employee Referral Bonus Program
• Paid Holidays, Disability, and Life/AD&D for full-time employees
• Wellness Programs
• Employee Assistance Programs and more
*Benefit offerings based on employment status
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Other facts
About Luminis Health
Luminis Health is a nationally recognized health system in Maryland. With more than 700 inpatient beds and nearly 100 sites of care across the region, including Anne Arundel Medical Center, Doctors Community Medical Center, J. Kent McNew Family Medical Center, Pathways, and Luminis Health Clinical Enterprise, we are committed to providing easy access to high-quality care, near to where people, live, work and play.
Luminis Health believes that health and wellness are fundamental to everyone and by working side by side with our community, patients, and partners, we generate a positive impact for all. We are committed to diversity and addressing health equity. We believe access to healthcare should be refreshingly easy.
Our R.I.S.E. values of Respect, Inclusion, Service, and Excellence guide how we work together every day.
We will enhance the health of the people and communities we serve, because we believe that we're better together. All of us.
What you'll do
- The Senior Reimbursement Analyst is responsible for analyzing and preparing healthcare reimbursement data, ensuring compliance with regulatory reporting requirements. This role also involves leveraging data analytics to optimize reimbursement strategies and providing financial insights for decision-making.
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