Reimbursement Analyst (Troy) Job at Pride Health, Troy, MI

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  • Pride Health
  • Troy, MI

Job Description

Job Title: Finance Reimbursement Analyst

Location: Troy, MI 48083

Work Model: Hybrid in-office on Wednesdays. Fully remote available for exceptional candidates.

Job Category: Direct Hire

Job Summary

Under minimal supervision, the Reimbursement Analyst independently leads complex financial and data analysis to evaluate rate proposals, contract terms, and health plan reimbursement. This role proactively identifies areas for improvement in methodologies, processes, and rates, and implements solutions to optimize reimbursement across the health system.

Key Responsibilities

  • Lead financial and data analysis to assess contracted rates and reimbursement methodologies.
  • Analyze rate proposals and contract terms; evaluate financial impacts and ensure reimbursement terms are accurate and complete.
  • Develop financial reporting and analytics using tools including EPSi, SQL, Epic Clarity, and Power BI .
  • Monitor payer reporting trends and provide actionable recommendations to Contracting leadership.
  • Create and maintain metrics to compare organization reimbursement against industry benchmarks.
  • Manage the rate review process for both existing and proposed contracts.
  • Coordinate with the contract modeling team to maintain contract management/pricing systems.
  • Ensure data integrity through continuous monitoring of financial systems.
  • Stay current with reimbursement methodologies, payer policies, and regulatory changes.
  • Participate in special projects and attend committee meetings as assigned.
  • Support financial projects across the health system.

Required Skills & Abilities

  • Strong analytical and critical-thinking ability.
  • High attention to detail.
  • Proficiency in Microsoft Excel (queries, reports, pivots, What-If scenarios, database management).
  • Skilled in data extraction and reporting tools ( EPSi, SQL, Epic Clarity, Power BI ).
  • Excellent written and verbal communication skills.
  • Strong organizational and interpersonal skills.
  • Understanding of managed care reimbursement methodologies, coding, and terminology.
  • Coding/billing experience preferred.

Education

  • Bachelors degree required (Finance, Accounting, Business, or related field preferred).

Job Tags

Contract work, Part time, Work at office,

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