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Provider Reimbursement Analyst Jobs (NOW HIRING)

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 ...

State of Indiana

Reimbursement Analyst

Indianapolis, IN · On-site

$59K/yr

The Reimbursement Analyst role is focused on support of supplemental payment programs and ... You will provide support for implementing rating methodology changes and rate updates for waiver ...

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 ...

Elevance Health

Provider Reimbursement Manager

Richmond, VA · On-site

$80K - $153K/yr

Manages key components of the provider reimbursement strategy. Serves as the primary point of ... Partner cross-functionally with clinical, coding, analytics, and technology teams to ensure edits ...

New

Elevance Health

Provider Reimbursement Manager

Richmond, VA · On-site

$80K - $153K/yr

Provider Reimbursement Manager Location: Louisville KY, Indianapolis IN, Richmond VA, Atlanta GA ... Partner cross-functionally with clinical, coding, analytics, and technology teams to ensure edits ...

New

Elevance Health

Provider Reimbursement Manager

Mason, OH · On-site

$80K - $153K/yr

Provider Reimbursement Manager Location: Louisville KY, Indianapolis IN, Richmond VA, Atlanta GA ... Partner cross-functionally with clinical, coding, analytics, and technology teams to ensure edits ...

New

Elevance Health

Provider Reimbursement Manager

Mason, OH · On-site

$80K - $153K/yr

Manages key components of the provider reimbursement strategy. Serves as the primary point of ... Partner cross-functionally with clinical, coding, analytics, and technology teams to ensure edits ...

New

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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.
Reimbursement Analyst

Reimbursement Analyst

ProCare Rx

Gainesville, GA

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago

Job description

PRINCIPLE RESPONSIBILITIES (include but are not limited to):

  • Analyze pharmacy claims data utilization to identify financial trends, opportunities, and potential risks, including changes to profit margins.
  • Work with Pharmacy Network to identify new contract requirements and methods to validate set up in the system.
  • Perform scheduled review and quality assurance of reimbursement in the system.
  • Assist the legal team by monitoring, understanding, and acting on state MAC laws.
  • Monitor and maintain contractual Generic Effective Rate agreements.
  • Assist with implementation of new MAC tables for new clients.
  • Assist with MAC review appeals from pharmacies & clients.
  • Communicate MAC prices of new drugs with other team members.

REQUIREMENTS

  • Bachelor’s degree in Finance, Economics or other business-related field, or 4+ years of financial or pricing analysis experience in PBM or Healthcare related field preferred.
  • Demonstrate expanded understanding of advanced Excel functionality preferred.
  • Aptitude to learn or demonstrated understanding of databases and query languages (e.g., SQL, DBF, Access, SAS, etc.) preferred.
  • Ability to effectively communicate, verbally and in writing, potentially technical information to a non-technical audience preferred.
  • Ability to work independently and in a fast-paced environment preferred.
  • Strong analytical and problem-solving skills preferred.

PHYSICAL DEMANDS

Requires sitting, standing, and occasional light lifting.

The Perks of Joining Our Team:

We believe in taking care of our team.  You'll enjoy a comprehensive benefits package designed to support your well-being and financial future:

  • Comprehensive Health Benefits: Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance.
  • Time to Recharge: Paid vacation and holiday pay.
  • Focus on Your Wellness: We offer a robust Employee Wellness Program.
  • Invest in Your Future: 401 k with a company match.
  • Support System: Employee Assistance Program provides confidential support and counseling.
  • Get Rewarded for Referring Great People:  Employee referral program.

ProCare Rx will never ask for a financial commitment from an applicant, as part of our recruitment process.  All interviews are conducted in-person OR through video conference invitations from official company emails.  For inquiries, please contact our official recruitment team at HumanResources@procarerx.com.

ProCare Rx is an Equal Opportunity Employer.

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