Job Summary

A company is looking for a Medicaid (PPS) Provider Hospital Reimbursement Methodologies Analyst.

Key Responsibilities:

• Researching state-specific Medicaid reimbursement methodologies for hospitals and facilities
• Developing expertise in complex groupers (EAPG, APR-DRG, MS-DRG, etc) utilized in Medicaid reimbursement
• Supporting implementation of new Medicaid pricers and assisting with requirements development

Required Qualifications:

• 3+ years of experience researching state Medicaid hospital reimbursement methodologies
• 2+ years of experience researching MS-DRG, APR-DRG, and/or EAPG grouper logic
• Experience processing or reviewing facility claims
• Prior professional experience utilizing Microsoft Excel
• Meet company's WAH policy