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Medicare Reimbursement Analyst Jobs (NOW HIRING)

Merrimack Health

Senior Reimbursement Analyst

Lawrence, MA · On-site

$43.28 - $64.93/hr

As the Senior Reimbursement Analyst, you will be under the direction of the Director of ... Prepare third party cost reports. (Medicare, Medicaid, Other State Specific Filings). * Prepare and ...

Merrimack Health

Senior Reimbursement Analyst

Lawrence, MA · On-site

$43.28 - $64.93/hr

As the Senior Reimbursement Analyst, you will be under the direction of the Director of ... Prepare third party cost reports. (Medicare, Medicaid, Other State Specific Filings). * Prepare and ...

ECU Health

Sr. Reimbursement Analyst

Greenville, NC · On-site

$68K - $100K/yr

The position maintains current knowledge of Medicare, Medicaid and other State and Federal regulations. The Sr. Reimbursement Analyst interacts with customers and ensures value is delivered and ...

Essentia Health

Senior Reimbursement Analyst

Fargo, ND · Remote

Responsible for preparing accurate and timely Medicare and Medicaid Cost Reports, Medicaid DSH surveys and other agency surveys on an annual basis. Prepares various reimbursement analyses, reviews ...

Essentia Health

Senior Reimbursement Analyst

Fargo, ND · On-site +1

Responsible for preparing accurate and timely Medicare and Medicaid Cost Reports, Medicaid DSH surveys and other agency surveys on an annual basis. Prepares various reimbursement analyses, reviews ...

LCMC Health

$79K - $98K/yr

Computes interim Medicare/Medicaid settlements and impact on reimbursement for the hospital ... Develops techniques for effective analysis of billing and collections efforts. Develops, prepares ...

Prime Healthcare

Reimbursement Analyst

Lewiston, ME · On-site

$55K - $74K/yr

The Reimbursement Analyst will work on various projects, ad hoc request, and monthly/quarterly ... with Medicare and Medicaid cost report. 3. Experience working with Excel (v-lookups, sumif ...

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How much do medicare reimbursement analyst jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for medicare reimbursement analyst in the United States is $32.54, according to ZipRecruiter salary data. Most workers in this role earn between $25.72 and $37.74 per hour, depending on experience, location, and employer.

What does a Medicare Reimbursement Analyst do?

A Medicare Reimbursement Analyst is responsible for analyzing and ensuring healthcare organizations receive accurate payments from Medicare for the services they provide to patients. They review billing codes, monitor compliance with federal regulations, and resolve discrepancies in reimbursement. These analysts also identify opportunities to optimize reimbursement processes and may assist with audits or appeals related to Medicare claims. Their work ensures that healthcare providers are properly compensated and remain compliant with complex Medicare rules.

What are the key skills and qualifications needed to thrive as a Medicare Reimbursement Analyst?

To thrive as a Medicare Reimbursement Analyst, you need a strong understanding of healthcare reimbursement methodologies, Medicare regulations, and analytical skills, typically supported by a degree in finance, accounting, or healthcare administration. Familiarity with Medicare billing systems, claims processing software, and data analysis tools such as Excel or specialized healthcare analytics platforms is crucial. Attention to detail, problem-solving abilities, and effective communication help analysts interpret complex regulations and collaborate with stakeholders. These skills ensure accurate reimbursements, regulatory compliance, and optimal financial performance for healthcare organizations.

What are some of the common challenges faced by Medicare Reimbursement Analysts in ensuring accurate claims processing?

Medicare Reimbursement Analysts often grapple with complex and frequently changing regulations, which can make it challenging to ensure claims are compliant and processed accurately. They must stay updated on federal and state policy changes, manage large volumes of data, and coordinate with clinical, billing, and finance teams to resolve discrepancies. Attention to detail and strong analytical skills are essential, as errors can lead to delayed payments or audits. Collaborating effectively across departments and maintaining up-to-date knowledge are key to overcoming these challenges.

What is the difference between Medicare Reimbursement Analyst vs Medical Billing Specialist?

AspectMedicare Reimbursement AnalystMedical Billing Specialist
CredentialsTypically requires a degree in health administration, finance, or related field; certifications like CPC or CCS are commonHigh school diploma or equivalent; certifications like CPC can be beneficial
Work EnvironmentHealthcare organizations, insurance companies, government agenciesMedical offices, clinics, hospitals, billing companies
Primary FocusAnalyzing Medicare reimbursement policies, ensuring compliance, optimizing reimbursement ratesProcessing patient billing, coding, and submitting claims

While both roles involve healthcare finance, Medicare Reimbursement Analysts focus on reimbursement policies and compliance for Medicare, whereas Medical Billing Specialists handle day-to-day billing and coding tasks. The analyst role often requires more specialized knowledge of Medicare regulations and may involve higher-level analysis.

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Medicare Reimbursement Analyst jobs near you
Infographic showing various Medicare Reimbursement Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 16% Part Time, and 11% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $67,679 per year, or $32.5 per hour.

Hospital Reimbursement Analyst

Medical Mutual of Ohio

Cleveland, OH • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago

Medical Mutual of Ohio rating

8.6

Company rating: 8.6 out of 10

Based on 17 frontline employees who took The Breakroom Quiz

92nd of 311 rated insurance

Job description

Medical Mutual employees must submit their applications through MySource.
Note: The Hospital Reimbursement Analyst should have a strong understanding of hospital reimbursement methodologies. Also, this is a hybrid role requiring 3 days per week on-site in our Brooklyn, Ohio office.
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.
Performs routine to moderately complex financial analyses to support provider contracting strategies for Professional Providers. Begins to gain exposure to Institutional Provider analytics. Collaborates with Network Management and senior analysts to deliver actionable insights that support business initiatives and decision-making. Maintains market intelligence and contributes to the evaluation of network performance.
Responsibilities
Hospital Reimbursement Analyst
  • Develop complex deal models in collaboration with Network Management to support contracting. Analyze performance using utilization, cost, contract valuation, competitive benchmarks, and financial impact metrics. Communicate findings to support decision-making.
  • Support rate strategy development by identifying opportunities to optimize contracted rates and protect favorable structures through financial analysis.
  • Update and validate provider rate loading to ensure accuracy and compliance with contract terms.
  • Analyze emerging payment models and pricing strategies. Apply knowledge of commercial and Medicare reimbursement policies to inform contracting decisions.
  • Provide tactical support to senior analysts by extracting, cleaning, and preparing data for robust quantitative analysis.
  • Forecast contract rates and utilization trends. Build financial models and 'what-if' scenarios using claims and healthcare data.
  • Assist in building and validating rate methodologies. Ensure documentation is clear, repeatable, and aligned with update timelines.
  • Interpret complex contract language to assess financial implications of proposed changes.
  • Performs other duties as assigned.

Senior Hospital Reimbursement Analyst
  • Collaborate with Network Management to shape rate strategies and contract methodologies that optimize financial outcomes. Identify opportunities to enhance or safeguard favorable rate structures by analyzing the financial impact of corporate initiatives, including policy changes. Deliver strategic insights through clear communication of recommendations, analytical summaries, and presentations to senior leadership.
  • Build and refine complex deal models in collaboration with Network Management to support contracting efforts. Apply advanced analytical techniques and business acumen to evaluate deal projections, benchmark performance, and assess financial impacts using utilization data, cost trends, contract valuation, and competitive analysis.
  • Ensure accuracy and consistency in provider rate loading through regular updates and quality assurance reviews.
  • Mentor and guide junior analysts, providing training, support, and quality oversight. Serve as a resource for resolving complex analytical and operational issues.
  • Partner with Actuaries and Underwriting to assess regional financial impacts of contracted rates and support short- and long-term forecasting.
  • Develops, builds and quality checks Institutional Reimbursement Methodologies, ensuring documentation around each build is clear and repeatable. Documents what Methodologies need to be updated when.
  • Forecasts contract rates, utilization trends and creates financial models using claims and other healthcare data. Creates 'what if' scenarios to help guide analytical decision making.
  • Interpret complex contract language to assess financial implications of proposed changes and support negotiation strategies.
  • Investigate claim disputes to validate pricing accuracy and conduct root cause analysis on inquiry data. Recommend system enhancements, targeted training, and process improvements to mitigate future errors and strengthen operational integrity.
  • Performs other duties as assigned.

Qualifications
Hospital Reimbursement Analyst
Education and Experience
  • Bachelor's degree in business or healthcare administration, finance, accounting, or related field.
  • Equivalent education and experience directly related to the role may substitute for a degree.
  • 3-4 years of experience as a Provider Reimbursement Analyst or equivalent progressive health care administration experience with an emphasis on Provider Contracting/Network Management.

Technical Skills and Knowledge
  • Intermediate Microsoft Office Excel, Word, Access, and PowerPoint
  • Working knowledge of SAS and/or SQL; knowledge of writing queries and analytical reports preferred.
  • Ability to quickly learn and use software business intelligence tools.
  • Experience working with relational databases.

Senior Hospital Reimbursement Analyst
Education and Experience
  • Bachelor's degree in business or healthcare administration, finance, accounting or related field.
  • Equivalent education and experience directly related to the role may substitute for a degree.
  • 5 years of experience as a Provider Reimbursement Analyst or equivalent progressive health care administration experience with an emphasis on Provider Contracting/Network Management.

Technical Skills and Knowledge
  • Advanced financial analysis skills including forecasting and payment modeling.
  • Advanced computer skills including Excel, Word, Access, and PowerPoint.
  • Ability to utilize SAS programming language in assigned analysis.
  • Ability to quickly learn and use software BI tools.
  • Experience working with relational databases.
  • Ability to apply technical skills and operational knowledge to produce actionable results and analysis. #LI-JT1

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
A Great Place to Work:
  • We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
  • Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
  • On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
  • Discounts at many places in and around town, just for being a Medical Mutual team member.
  • The opportunity to earn cash rewards for shopping with our customers.
  • Business casual attire, including jeans.

Excellent Benefits and Compensation:
  • Employee bonus program.
  • 401(k) with company match up to 4% and an additional company contribution.
  • Health Savings Account with a company matching contribution.
  • Excellent medical, dental, vision, life and disability insurance - insurance is what we do best, and we make affordable coverage for our team a priority.
  • Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
  • Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
  • After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:
  • Career development programs and classes.
  • Mentoring and coaching to help you advance in your career.
  • Tuition reimbursement up to $5,250 per year, the IRS maximum.
  • Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:
Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.
There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.
We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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