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Provider Reimbursement Analyst Jobs (NOW HIRING)

UPMC Health Plan

Reimbursement Analyst

Pittsburgh, PA · Hybrid

The Reimbursement Analyst is a middle level analytical position responsible for all aspects of provider reimbursement. This includes establishing and maintaining compensation rates for hospitals ...

Advocate Aurora Health

Reimbursement Analyst

Oak Brook, IL · On-site +1

$33.05 - $49.60/hr

... analysis, modeling, reporting, and reviewing of proper reimbursement from third party payers in ... Assists in preparation and provides necessary information required for the completion of system ...

NeoGenomics Laboratories

Reimbursement Analyst

$45K - $65K/yr

Not only do we provide career coaches internally, but we offer many training opportunities to ... NeoGenomics is looking for a Strategic Reimbursement Analyst who wants to continue to learn in ...

Advocate Aurora Health

Reimbursement Analyst

Milwaukee, WI · On-site +1

$33.05 - $49.60/hr

... analysis, modeling, reporting, and reviewing of proper reimbursement from third party payers in ... Assists in preparation and provides necessary information required for the completion of system ...

ProCare Rx

Reimbursement Analyst

Gainesville, GA · On-site

Analyze pharmacy claims data utilization to identify financial trends, opportunities, and potential ... Employee Assistance Program provides confidential support and counseling. * Get Rewarded for ...

ProCare Rx

Reimbursement Analyst

Gainesville, GA

Analyze pharmacy claims data utilization to identify financial trends, opportunities, and potential ... Employee Assistance Program provides confidential support and counseling. * Get Rewarded for ...

Medasource

Reimbursement Analyst III

Sacramento, CA · On-site

The analyst serves as a subject matter expert in reimbursement methodologies and provides financial impact modeling based on regulatory changes. This role partners closely with accounting and finance ...

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Provider Reimbursement Analyst information

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How much do provider reimbursement analyst jobs pay per hour?

As of Jul 5, 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.
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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 98% Full Time, 1% Part Time, and 1% 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.
Reimbursement Analyst

Reimbursement Analyst

UPMC Health Plan

Pittsburgh, PA • Hybrid

Other

Posted 15 days ago

Job description

Purpose:
The UPMC Health Plan is seeking a Reimbursement Analyst to fill an opening in our Hospital Reimbursement department. This role offers a flexible work arrangement and is required to be in office in downtown Pittsburgh 3 days per week; however; the remaining days can be worked remotely.

The Reimbursement Analyst is a middle level analytical position responsible for all aspects of provider reimbursement. This includes establishing and maintaining compensation rates for hospitals, physicians, and ancillary services. Knowledge of fee schedules, case rates, per-diems, PDPM, as well as any other reimbursement methodology is required.

This role is Hybrid and will require 3 days onsite in Downtown Pittsburgh

Responsibilities:

  • Work with Reimbursement Specialist in developing / negotiating reimbursement rates for new providers. Including accurate, easy to understand analysis of the negotiated rates.
  • Monitor and review new pricing configuration to assure the provider is pricing accurately as contracted. This includes maintaining documentation of your review.
  • Resolve reimbursement issues.
  • Update and maintain hospital reimbursement rate summary
  • Act as company expert on all reimbursement issues.
  • Complete special projects accurately and timely.
  • Out of network negotiations when required.
  • Monitor Calendar to assure all action items are completed proactively.
  • Update and maintain hospital reimbursement reports for all product lines. Reports include inpatient base rate comparisons, outpatient reimbursement comparisons to UPMC OP fee schedule, Observation cost per case.
  • Resolve problems that result in claims pending.
  • Work with configuration staff when negotiating to assure negotiated rates are operational.
  • Analyze and compare fee schedules.
  • Attend meetings when required.
  • Analyze all reimbursement, including outliers, transfer adjustments, etc.
  • Bachelor's Degree in health care administration, business and/or other related discipline (Related experience in a health care administration setting may be substituted for educational requirements).
  • Excellent planning, communication, documentation, organizational, analytical, and problem-solving abilities.
  • Advanced mathematical skills.
  • Ability to interpret and summarize results of various analysis in a timely and meaningful way.
  • Strong computer skills, including expert knowledge of Access and Excel.
  • Experience with a physician practice, hospital, ancillary provider, health insurance company or integrated delivery system is preferred.
  • Preferred individual needs to have in depth understanding of managed care delivery systems and have had direct experience with reimbursement.
  • Knowledge of ICD-10CM, CPT4, Revenue Codes, DRGs, base rates, Medicare methodologies, Medicaid methodologies, HCPCS coding and related governmental guidelines and provider reimbursement methodologies preferred.
  • Ability to work cooperatively with multidisciplinary teams and/or independently.
  • Ability to re-engineer processes to positively impact productivity in terms of timeliness and accuracy.
    UPMC is an Equal Opportunity Employer/Disability/Veteran

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