Business & Reimbursement Analyst - Full-Time

**Position Summary:** Evaluates operational needs for new programs and services and translates business analysis and research into actionable business plans. Supports the financial sustainability of the organization through timely, accurate, and ongoing analysis of payor reimbursement. Identifies trends in payments and denials, ensures claims processing is accurate and compliant with reimbursement terms and payor policies, and resolves reimbursement issues. Serves as a subject matter expert in payor reimbursement policies, appeal processes, and regulatory requirements. Supports business development through market analysis, feasibility assessments, and financial modeling for new or expanded service lines. Collaborates with cross-functional teams, including clinical, operations, and finance, to implement business and reimbursement initiatives. Participates in production of price transparency files in accordance with regulatory requirements and coordinates related staff education. **Qualifications** : **Education** * Bachelor's Degree in relevant field required. * Five (5) years' progressive healthcare revenue cycle experience required. * Professional or academic experience with statistics, analytics and/or data analysis required. **Certifications** * American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) coding certification preferred. **Experience** * Healthcare financial systems experience (Epic, Cerner, Meditech, or other EHR/RCM tools). * Experience with healthcare financial systems (e.g., Epic, Cerner, Meditech) and data visualization tools (Tableau, Power BI, advanced Excel) preferred. **Primary Duties and Responsibilities:**** ** * Collaborate with leadership and staff to translate business analysis into actionable business plans. * Conduct ongoing analysis of payor reimbursement to support financial sustainability and identify trends in payments and denials. * Resolve reimbursement issues and ensure claims processing aligns with payor agreements and compliance standards. * Serve as subject matter expert on payor reimbursement policies, appeal procedures, and regulatory guidelines. * Perform ad hoc financial and operational analyses to support evolving business needs and strategic decisions. * Evaluate existing and proposed contract rates to ensure competitiveness and alignment with organizational goals. * Develop and maintain price transparency files in accordance with federal and state regulatory requirements in collaboration with Revenue Integrity Analyst. * Coordinate and deliver training sessions on reimbursement procedures and payor policies for internal stakeholders. * Monitor and report on reimbursement performance metrics, providing insights to improve revenue cycle efficiency. * Support strategic business development initiatives through data-driven recommendations, market analysis, and financial modeling. ** ** **Skills and Abilities:** * Skilled in exercising strong analytical and problem-solving skills; ability to synthesize complex data into actionable insights. * Advanced understanding of revenue cycle processes and the ability to work collaboratively with multiple departments. * Advanced ability to evaluate and translate payor reimbursement contract language and policies into business requirements. * Strong attention to detail and high degree of accuracy. * Self-directed and thorough * Advanced skills in Microsoft Office products (Excel, Word, PowerPoint) * Excellent interpersonal, written, and verbal communication skills. * Ability to apply corporate policies and procedures to daily challenges. * Strong organizational and planning skills, including prioritization and adaptation to interruptions. * Resource management skills, including effective time management. * Professionalism, discretion, and the ability to maintain confidentiality. **General Information:** The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities and job skills required. ** ** **Physical Demands and Work Environment:** 1. Primarily sedentary office-based work; occasional lifting of up to 25 lbs. 2. Able to sit, stand, walk, bend, squat, reach, and stretch frequently. 3. Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone. 4. Requires frequent use of computer. 5. Must demonstrate manual dexterity. 6. Must be able to perform the primary duties and responsibilities of the job with or without reasonable accommodation. ** ** **Expectations for All Employees** Support the organization's mission, vision and values by adhering to the behavioral standards of Grande Ronde Hospital. Comply with all laws and regulations affecting Grande Ronde Hospital. Be familiar with and adhere to the Personnel Policy Manual and the Code of Conduct and support the Grande Ronde Hospital Compliance Program. Effective communication skills and the ability work effectively with people from various backgrounds are critical. **Mission** : Grande Ronde Hospital and Clinics will ensure access to high quality, cost-effective health care in a safe and customer-friendly environment for all those in need of our services. **Vision** : Quality health care is our mission. Patients are our passion. **Values** : Creativity, Compassion, Collaboration, Credibility **Compensation** $36.77 - $51.09 Per Hour DOE **Shift Details** 8am - 5pm, Monday - Friday