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Provider Reimbursement Analyst Jobs (NOW HIRING)

NeoGenomics Laboratories

Reimbursement Analyst

$44K - $66K/yr

As an employer, we promise to provide you with a purpose driven mission in which you have the ... The Analyst supports reimbursement-focused projects by analyzing reimbursement data, creating ...

TEKsystems

Reimbursement Analyst

Cary, NC · Hybrid

$19.45/hr

As an Reimbursement Analyst you will partner cross-functionally and provide easily consumed requests for reimbursement which are well-documented and supported. Description - Perform detailed data ...

giftHEALTH Inc

Reimbursement Analyst

Columbus, OH · On-site

$24.81 - $29.18/hr

Our mission is to provide a seamless, personalized, and efficient healthcare experience for all our ... Position Summary A Reimbursement Analyst is responsible for being the primary point of contact in ...

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Provider Reimbursement Analyst information

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How much do provider reimbursement analyst jobs pay per hour?

As of Jun 12, 2026, the average hourly pay for provider 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 is the difference between Provider Reimbursement Analyst vs Billing Specialist?

AspectProvider Reimbursement AnalystBilling Specialist
CredentialsTypically requires a degree in healthcare administration, finance, or related field; certifications like CPC or CCS may be preferredUsually requires a high school diploma or associate degree; certifications like CPC are common
Work EnvironmentWorks in healthcare finance departments, analyzing reimbursement data, and ensuring accurate claims processingWorks in medical offices or billing companies, preparing and submitting claims to insurance companies
Employer & IndustryHospitals, insurance companies, healthcare consulting firmsMedical practices, billing companies, healthcare providers

The Provider Reimbursement Analyst focuses on analyzing and optimizing reimbursement processes, while the Billing Specialist handles the day-to-day billing and claims submission. Both roles require knowledge of healthcare billing, but the analyst role involves more financial analysis and reimbursement strategies.

What are the key skills and qualifications needed to thrive as a Provider Reimbursement Analyst, and why are they important?

To thrive as a Provider Reimbursement Analyst, you need strong analytical skills, a solid understanding of healthcare reimbursement methodologies, and typically a degree in finance, accounting, or a related field. Familiarity with claims processing systems, Excel, and data analysis tools, as well as knowledge of CMS regulations, is essential. Attention to detail, problem-solving abilities, and effective communication are important soft skills for this role. These skills ensure accurate payment processes, regulatory compliance, and clear collaboration with providers and internal teams.

What are Provider Reimbursement Analysts?

Provider Reimbursement Analysts are professionals who evaluate and process healthcare provider claims to ensure accurate payments according to contracts, regulations, and policies. They analyze reimbursement data, review payment methodologies, and resolve discrepancies or issues related to provider compensation. Their work ensures that healthcare providers are fairly compensated for their services, while helping health plans and organizations control costs and comply with regulatory requirements.

What are some common challenges a Provider Reimbursement Analyst faces when working with healthcare claims data?

Provider Reimbursement Analysts often encounter challenges related to the complexity and volume of healthcare claims data, including navigating multiple payer systems and ensuring data accuracy. Interpreting diverse contract terms and keeping up-to-date with frequent regulatory changes can also be demanding. Analysts must collaborate closely with providers, payers, and internal finance teams to resolve discrepancies, validate payments, and support process improvements. Attention to detail and strong analytical skills are essential in overcoming these challenges and ensuring fair, timely reimbursement.
More about Provider Reimbursement Analyst jobs
What cities are hiring for Provider Reimbursement Analyst jobs? Cities with the most Provider Reimbursement Analyst job openings:
What job categories do people searching Provider Reimbursement Analyst jobs look for? The top searched job categories for Provider Reimbursement Analyst jobs are:
Provider Reimbursement Analyst jobs near you
Infographic showing various Provider Reimbursement Analyst job openings in the United States as of June 2026, with employment types broken down into 3% Locum Tenens, 32% Full Time, 27% Part Time, and 38% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $67,679 per year, or $32.5 per hour.
Provider Reimbursement Analyst

Provider Reimbursement Analyst

Medical Mutual of Ohio

Cleveland, OH • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

Medical Mutual of Ohio rating

9.4

Company rating: 9.4 out of 10

Based on 15 frontline employees who took The Breakroom Quiz

13th of 261 rated insurance

Job description

**Medical Mutual employees must submit their applications through MySource.
Note: This is a hybrid role requiring 3 days per week on-site in our Brooklyn, Ohio office. Seeking applicants that reside within a 50-mile radius of the 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
Provider Reimbursement Analyst II
  • Analyze utilization, cost, contract valuation, competitive benchmarks, and financial impact data as directed. Translate findings into clear, actionable insights to support decision-making.
  • Update and validate provider rate loading to ensure accuracy and compliance with contract terms.
  • Provide tactical support to senior analysts by extracting and preparing data for robust quantitative analysis.
  • Extract and manipulate data from multiple sources to develop analytic datasets. Present findings in a clear and concise format.
  • Support rate strategy development and analyze emerging payment models to inform contracting decisions.
  • Assist in forecasting contract rates and utilization trends. Build basic financial models and 'what-if' scenarios using claims data.
  • Support fee schedule development and quality checks. Maintain clear documentation of updates and build processes.
  • Performs other duties as assigned.

Provider Reimbursement Analyst III
  • 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 Provider 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
Provider Reimbursement Analyst II
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.
  • 2 years of experience as a Provider Reimbursement Analyst or equivalent health care administration experience, preferably in managed care.
  • Provider Contracting/Network Management experience a plus.

Technical Skills and Knowledge
  • Intermediate Microsoft Office Excel, Word, Access, and PowerPoint skills.
  • Working knowledge of SAS and/or SQL; knowledge of writing queries and analytical reports preferred.
  • Experience working with relational databases.
  • Knowledge of provider contracting.

Provider Reimbursement Analyst III
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 Provider Reimbursement Analyst
Education and Experience
  • Bachelor's degree in business or healthcare administration, finance, accounting or related field.
  • 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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