Lead anesthesia reimbursement analytics including forecasting, payer trend analysis, variance identification, and strategic pricing recommendations across commercial, government, and out‑of‑network (OON) payment scenarios
Deliver advanced OON and No Surprises Act (NSA) analytics, support the IDR process, and build dashboards and financial models that inform leadership and drive pricing and revenue optimization
Support ASC chargemaster development and maintenance by performing detailed analyses, updating CPT mappings, setting fee parameters, and preparing recommended charge models based on contract terms, volume data, and payer requirements
Coordinate approvals and compliance workflows by tracking centers, reviewing operating agreements and payer notification language, preparing analysis and proposed chargemasters, and managing approvals
Prepare and distribute finalized chargemasters and documentation by creating distribution files, maintaining tracking logs, ensuring effective dates and notification timelines are met, and supporting payer notification and operational implementation
Oversee the execution of ad hoc reimbursement analyses and other custom analytics requested by leadership to drive informed strategic decisions
Requirements
Bachelor’s degree required, preferably in Finance, Accounting, Healthcare Administration, or a related field
5–7 years of progressive experience in healthcare analytics, pricing, or reimbursement analysis
Expertise in healthcare industry, managed care contracts, reimbursement methodologies, and pricing strategies
Track record of strong critical thinking and problem-solving ability
Fluency in Microsoft Office applications with advanced Excel skills required
Basic, working knowledge of SQL required
Ability to build and audit complex Excel-based financial models, analyze data, and translate analyses into specific, targeted actions to drive results
Expertise in working with complex and large volumes of data
Demonstrated ability to design, develop, and implement routine and custom reporting
Demonstrated ability to effectively communicate with C-suite and executive leadership.