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Payment Accuracy Analyst I- Burgess

 

Location: Burgess Company (Remote)

The Payment Policy Analyst I functions as an internal subject matter expert and works closely with cross functional team members In Medicare/Medicaid reimbursement methodologies, laws and regulations under the mentorship and guidance of a Senior Policy Analyst/Policy Lead. This hire must be organized, possess good communication and writing skills, and have impeccable attention to detail in order to meet assigned deliverables prior to the end of sprint cycles. The ideal candidate will be a true team player who is flexible to lend a hand on other projects as needed. This role presents an excellent opportunity to learn the basis of healthcare payment methodologies.

What you will do:

• Read and analyze Medicare data and policy including final rulings, daily transmittals, bulletins, policy manual updates, physician fee schedule (data file). Contact various government entities to clarify new and existing policy.

• Interpret and deliver business requirements covering reimbursement updates and payment policy changes and enhancement features for translation into software design specifications.

• Create detailed Excel formulas to explain and prove complex payment methodologies.

• Coordinate with developers, QA, data, client service and other team members to ensure that business requirements are implemented accurately and timely 

• Develop test claims for Developers, UAT and QA.

• Develop and maintain proficiency in the Company’s products (software, data) and services, including commercial contracting features as related to the specific area(s) assigned.

• Become familiar in assigned Provider Payment Systems like APC, DRG, RBRVS.

What you bring:

• Bachelor’s degree in a healthcare or comparable field.

• 1-3 years professional experience in healthcare, and working knowledge of health care reimbursement systems and methodologies

• Ability to effectively communicate and collaborate with diverse internal and external stakeholder groups and individuals.

• Ability to collect, research, and understand diverse information, and translate it into clear and concise written requirements.

• Ability to plan, prioritize, and balance the need for direction with self-motivated efforts.

• Strong interpersonal skills

Bonus points:

• Experience in an agile systems development life cycle (SDLC) environment.

• Experience using MS Office (Word, Excel, PowerPoint, Visio, Access) software applications

• Experience using various Web-based and other research sources and tools

 

 

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HealthEdge

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HealthEdge is an innovative software company that provides the only integrated financial, administrative and clinical software platform for healthcare payors.

Apply Now
Company Profile

Number of Employees

250 - 500 employees

Open Positions

28

Videos

Photos

Employee Testimonials

"Having spent many years leading Operations departments for various health plans, I joined HealthEdge because of the opportunity to use my background and expertise in an independent contributor role. I was impressed by the Company’s modern and practical approach to administering a core administration system. I am extremely glad to have shifted my career focus, and the employee focused culture, forward thinking, and spirit of teamwork are the qualities I enjoy most about working at HealthEdge."- Lynne, Manager, Configuration Center of Excellence

 
Lynne Hollinsworth   –   Manager, Configuration Center of Excellence

"I joined HealthEdge in the early startup days and thrived on the creative chaos and opportunities. While the company has grown significantly over the past 15 years, I appreciate the changing pace - issues of scaling, performance, mastering quality - these are the challenges where we are focused."- Adam Kacenjar

Adam Kacenjar   –   Program Director, Clinical Solutions

"HealthEdge is not just a software company, we are a solutions company, partnering with our customers to drive forward their business strategies using our products and services." - Dannette, EVP, Business Development

Dannette Coleman   –   EVP, Business Development

"I am lucky to be on a team that consistently works together, has each other’s backs and enjoys each other’s company! We are able to provide flexibility to team members as needed without diminishing our quality of work." -Kelly, Controller

Kelly Donovan   –   Controller

“There’s so much innovation happening within our walls, new ideas coming into the organization, and a culture that embraces trying new things and continuously improving existing processes. Our start-up type culture within a big company makes it a vibrant place to work.”- Melissa O'Dowd, Senior Director, Product Marketing

Melissa O'Dowd   –   Senior Director, Product Marketing

"I work at HealthEdge because it always presents me with new challenges which require professional and personal growth, and such growth is always rewarded by HealthEdge with career advancements and job satisfaction." -Simon, Technical Director

Simon Levin   –   Technical Director

“I like working at HealthEdge because I am part of a team that knows how to collaborate, focus on value and continuously improve. I choose HealthEdge because our technology is changing the healthcare industry for the better.” -Sarah, VP, Continuous Improvement

Sarah Clark   –   VP, Continuous Improvement

"I love working at HealthEdge because it is a forward-thinking company with a positive and open culture that supports the well-being of the people while providing innovative products that are invaluable. The culture promotes collaboration, teamwork and open communication. Everyone here counts, everyone is heard, and everyone supports eachother to grow and succeed." - Gail, Technical Writer

Gail Caldera   –   Technical Writer

"I joined HealthEdge to be part of a growing organization that is on a trajectory in becoming the leader in the payer market. The HealthEdge mission and core values were contributing factors for me becoming member of the Professional Services leadership team. As the Leader of the Project Management Team and Project Management Office, I am charged with attaining, retaining, and enabling high performing associates to deliver our next generation solutions to customers in order to support achievement of their strategic business objectives. HealthEdge is vested not only in products and services but talented people, providing an atmosphere of collaboration, innovation, diversity, and fun. Come join my team and be part of this great journey." - Marvin, VP, Project Management and PMO

Marvin Matthews   –   VP, Project Management and PMO

"I came to HealthEdge for an unmatched opportunity to further my career in IT with a growing business." -Dave, Director Infrastructure Engineering

Dave Paquette   –   Director, Infrastructure Engineering

"What stands out to me when I'm hiring is a customer-focused drive, a passion for problem solving and a desire to be part of something bigger than themselves." -Chris, VP of Customer Support

Chris Bulkley   –   VP, Customer Support

“I joined HealthEdge for the opportunity to be part of a growing company that is transforming and modernizing how health plans deliver services to their customers. I am excited to be part of a highly skilled team and look forward to further developing our implementation services and enabling our clients to better compete in the market by taking advantage of the latest tools and features of our products.” -Sarang, VP, Solutions Management

Sarang Muralidharan   –   VP, Solutions Management

“HealthEdge's culture is one that makes you feel comfortable to ask questions, where everyone is willing to help” -Abe, Technical Account Associate

Abe Gutierrez   –   Technical Account Associate

"I started at HealthEdge just over 3 years ago as a receptionist and was given chances to learn and grow. I quickly moved into HR where I was given even more opportunities to develop new skills for my career. I love that I am given the chance to use my strengths and overcome my weaknesses too! I am also fortunate to be a part of a great team," - Janice, HR Generalist

Janice Grenda   –   HR Generalist

“I am really enjoying every aspect of my role and the organization. I love that no matter what you are working on there is no one in the company that isn’t willing to roll up their sleeves and help out. From the top down it really is a team environment.”- Michele Forlenza, Account Executive

Michele Forlenza   –   Account Executive

"During my interviews, with HE, I experienced the phenomenon that had been described to me. I was excited by the energy of the team/family feeling I experienced. It was very evident that everyone was inspired and dedicated to both the future of the products but also to each other. As well, it was obvious that they were all truly devoted to client success. I knew I wanted to be part of that family and that I wanted to contribute to the overall future success" - Melissa, Senior Director of Business Consulting Services

Melissa Maulding   –   Senior Director, Business Consulting Services

“I joined HealthEdge to be part of building a next-generation product in a collaborative environment where innovative ideas are encouraged. I was attracted greatly by the management team and its vision, ambition and approachability.” - Danyi, Site Reliability Engineer

Danyi Cai   –   Site Reliability Engineer

“As an agile coach, I am glad to be part of a highly skilled team which is open to all the new methods and ideas to make them #1 in the healthcare software market.”- Sandhiya, Agile Coach

Sandhiya Krishnan   –   Agile Coach

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