Pricing Reimbursement Analyst I
Pricing Reimbursement Analyst I
Bring your claims and analyst expertise to a role where you will analyze and implement contract payment terms and rates for all provider types, for all regions and subsidaries. You will also be responsible for the analysis, development and maintenance of contract payments for all institutional, facility and professional healthcare providers negotiated by Cambia Health Solutions.
At Cambia, our values are fundamental to achieving our Cause of transforming the health care industry. They guide our actions and bring diverse perspectives together to improve the health care journey better for those we serve. All eight values are equally important and linked to the others: Empathy, Hope, Courage, Trust, Commitment, Innovation, Collaboration and Accountability. These values are not just words on paper - we live them every day.
Responsibilities & Requirements
Key Qualifications and Experience:
- Bachelor’s degree in business or related field and at least two years experience in the health care industry, with one year of project related experience, or the equivalent combination of education and work experience.
- Minimum of three years claims processing experience with knowledge of various methods of reimbursement.
- Ability to maintain significant involvement in corporate projects, assuming a leadership role as necessary.
- Ability to read and interpret provider contracts and understand medical and hospital pricing methodologies and billing practices.
- Demonstrated ability to complete highly detailed tasks with accuracy in a timely manner. Strong attention to detail is required.
- Demonstrated ability to work independently with minimal supervision and ability to determine when manager approval or involvement is required.
- Good understanding of the applicable Regence plans system(s) pricing logic. This person is characterized as a knowledgeable resource on pricing.
- Demonstrated ability to coordinate activities with varying levels of staff, with external agencies and medical professionals through strong verbal and written communication skills.
- Demonstrated analytical ability. Ability to identify problems, develop creative solutions and implement the chosen course of action in a timely and effective manner.
- Demonstrated maturity and tact, with the ability to be diplomatic and persuasive in situations requiring those qualities.
- Previous mainframe and PC experience is required.
Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.
Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 90 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.
If you’re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers’ engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.
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Cambia Health Solutions, headquartered in Portland, Oregon, is dedicated to transforming health care. We put people at the heart of everything we do as we work to make the health care system better and more economically sustainable for people and their families. Our company reaches more than 70 [...]