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Provider Reimbursement Analyst - Hoag Clinic Administration

Department:  Business Services
Status:  Full Time
Shift:  1st

Participates in the development and implementation of the Organization's strategic and financial planning for operating and capital, while ensuring timely and accurate financial information that is useful to management. 


Projects an image of professionalism in communication, appearance, and conduct. Supports the department and organization mission. Maintains a working knowledge of departmental standard operating procedures. This knowledge requires the use of specialized systems and computer software. Other duties as assigned. 


Job Specific Essential Functions:


  • Manage client group of IPA providers to ensure they receive accurate and timely payments for their services under Hoag Clinic contracts and supporting remittance data. 
  • Coordinate with the Accounting team to reconcile payment batches. 
  • Provider perfect service to providers and their office staff when they call in to inquire about payment research. 
  • Create reports and analysis demonstrating performance and trends on key metrics. 
  • EPSi financial system maintenance related to data loading, data grooming, and dictionary upkeep. 
  • Create and distribute monthly, biweekly, and daily financial reports to various management teams.
  • Participate in the setup and creation of the Capital Budget. 
  • Assist in the creation and reconciliation of the operating budget. This includes working to ensure the directives of the financial leadership team are understood and implemented by the organization's direct operational managers. 
  • Ensure all active measures and dashboards in EPSi and Qlikview are evaluated to show timely and accurate data. 
  • Performs other duties as assigned. 


Education, Training, and Experience:



  • Bachelor's degree in accounting/finance preferred or another related field. 
  • At least 2 years of exposure to medical billing and/or claims; familiarity with 837-835 transaction data. 



  • Minimum of 1-4 years' experience as a financial analyst or related experience. 
  • Hospital/healthcare experience desirable but not mandatory. 


Skills or Other Qualifications



  • Proficiency in MS Word, Excel, PowerPoint, and Access. 
  • Good written, oral communication, interpersonal, organizational skills, and familiarity with computerized financial systems. 
  • The ability to work both independently and as a team. 
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