IS Business Intelligence Developer – Epic
Ochsner Health
OracleSQLTableau
Senior Business Intelligence Engineer – Medicare, PPS Provider Hospital Reimbursement
Humana
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $89,000 - $121,400 per year
Job Level
Senior
About the role
- Responsible for maintenance and support of Medicare outpatient provider reimbursement for hospitals and facilities
- Work closely with IT, pricing software vendor, CIS BSS, claims operations, and other business teams
- Develop and maintain expertise in complex Medicare reimbursement methodologies
- Researching and maintaining expertise in Medicare methodologies and supporting pricer projects
Requirements
- Expertise in Medicare Outpatient Prospective Payment System reimbursement methodologies (OPPS, ASC, FQHC, etc.)
- Expertise in Medicare Integrated Outpatient Code Editor (I/OCE) logic
- Analyzing and interpreting CMS Regulatory documentation for Medicare Prospective Payment Systems
- Experience with pricing software vendor specifications and system changes needed to accommodate CMS logic
- Ability to create and execute comprehensive test plans
- Strong problem-solving skills including root cause analysis
Benefits
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- Short-term and long-term disability
- Life insurance
- Many other opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
Medicare reimbursement methodologiesMedicare Outpatient Prospective Payment SystemIntegrated Outpatient Code Editor logicCMS Regulatory documentation analysispricing software specificationstest plan creation and executionroot cause analysis
Soft skills
problem-solving
