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← Optima Dermatology

Payor Reimbursement & Claims Remediation Specialist

Optima Dermatology
Location
Portsmouth, NH
Posted
16 days ago
Department
RCM
What they actually want (must-haves)
  • Minimum of 5 years of experience in Revenue Cycle Management, payor operations, claims analysis, or related healthcare reimbursement roles
  • Demonstrated experience analyzing reimbursement and payment data, including expected versus actual payment and fee schedule variance analysis
  • Working experience using Power BI or a comparable business intelligence tool to run reports and extract data, including slicers and filters
  • Strong analytical and problem-solving skills with the ability to identify systemic issues, patterns of incorrect payment, and root causes
  • Excellent written and verbal communication skills, including the ability to communicate effectively with payor leadership
  • Ability to manage multiple projects simultaneously and prioritize work based on financial and operational impact
Nice to have
  • Bachelor's degree in healthcare administration, business, finance, data analytics, or a related field strongly preferred, or an equivalent combination of education and experience
What the job really is

The Payor Reimbursement & Claims Remediation Analyst at Optima Dermatology will analyze payor payment performance and resolve claims issues to ensure accurate and timely reimbursements. This role involves hands-on data analysis using Power BI, leading remediation efforts for underpayments and incorrect claims, and serving as the primary liaison between various operational teams and payors. The Analyst will also prepare reports and data files to support payor remediation projects and collaborate with cross-functional teams to improve processes.

Benefits
  • Generous health, dental, vision, disability, and life insurance
Things to weigh
  • No specific salary listed
  • Position is hybrid, requiring presence in Portsmouth, NH
  • Role involves significant data analysis and operational remediation, which may be high-pressure
Job score2.8/5
Benefits1/5
Freshness4/5
Career value4/5
Role clarity5/5
Pay transparency0/5

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