The Reimbursement Analyst is responsible for fee schedule analysis, documentation, system updates, issue resolution, and collaboration with IT and other teams to ensure accurate reimbursement processes.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM™ intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers’ Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years.
Position Summary:
The Reimbursement Analyst (RA) serves as a Fee Schedule Subject Matter Expert (FS SME) and is a key
contributor within the Reimbursement Services Department. This position is responsible for the research,
analysis, documentation, implementation, maintenance, and continuous improvement of complex fee
schedule calculation systems that support the Enforcer business product.
Success in this role requires advanced knowledge of jurisdiction-specific healthcare fee schedule
methodologies, medical coding standards, and strong technical proficiency. The Reimbursement Analyst
executes table data loads, state rules updates, develops structured functional and technical business
documentation, and collaborates cross-functionally with teams such as IT, Data Analytics, Implementation,
Product Support, Operations, and Training.
Key Responsibilities
- Collaborate with individuals from every facet of the organization, identify and analyze jurisdictional fee schedule guidelines, draft effective FS SME Logic documents, summarize said rules for end-user comprehension, and coordinate User Acceptance Testing (UAT) in the development (DEV) environment to ensure reimbursement requirements are executed accurately prior to deployment to production (PROD).
- Identify, investigate, and resolve reimbursement-related issues for jurisdiction-specific and hospital (e.g., inpatient, outpatient) and professional fee schedules.
- Partner directly with IT development to define and translate business requirements for timely and precise fee schedule coding, testing, troubleshooting, and deployment.
- Track and access ongoing updates to published and upcoming new fee schedules, conducting periodic reviews to ensure rule accuracy and compliance.
- Monitor system reminders, alerts, error logs, data integrity reports, and anomalies within PROD data to maintain operational reliability.
- Update fee schedule state rules and load associated data tables promptly and accurately.
- Support communication, training, and documentation efforts related to fee schedule updates.
- Exercise independent judgment and discretion in executing responsibilities outlined above.
- Perform additional duties as assigned.
Requirements and Qualifications
- Bachelor’s degree required
- Minimum of 3 years of experience in healthcare reimbursement analysis
- Proficiency in medical coding, billing, claims processing, and IT systems.
- Expertise in MS Office, especially Word, Excel, and Outlook.
- Strong understanding of hospital and professional coding and reimbursement methodologies is mandatory.
- Experience in working with IT and system development is a plus.
- A combination of equivalent education and experience will be considered.
- Must be able to perform all essential job functions effectively; reasonable accommodation will be provided for qualified individuals with disabilities.
- Consistent and reliable attendance is required.
Special Considerations and Prerequisites
- Experienced in drafting business requirement specifications for hospital and professional reimbursement fee schedules.
- Thrives in a role that requires autonomy, accountability, and self-direction in a remote setting.
- Familiarity with Medicare and Military (Veterans Admin, Tricare) reimbursement methodologies is highly preferred.
- Excels in a dynamic, fast-paced environment while independently managing multiple projects and competing priorities without the need for continuous oversight.
- Exceptionally organized, detail-oriented, and equipped with strong communication skills.
- Superior analytical and problem-solving capabilities.
EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.
EnableComp recruits, develops and retains the industry's top talent. As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people. We believe that investing in our employees is the key to our success, and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here. At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies. If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you.
Don’t just take our word for it! Hear what our people are saying:
“I love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other.” – Revenue Specialist
“I enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun.” – Supervisor, Operations
Top Skills
Billing
Claims Processing
It Systems
Medical Coding
MS Office
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