Remote Appeals Analyst Jobs in Decatur, GA (NOW HIRING)

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At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be.  We provide: 

• Comprehensive health benefits that start day1 
• Student Loan Repayment Assistance & Reimbursement Programs 
• Family-focused benefits  
• Wellness incentives 
• Ongoing mentorship, development, and leadership programs  
• And more  

Work Location: Atlanta, GA

Overview:

• Partners directly with the Corporate Director of Government Reimbursement as a strategic operator and project leader, driving complex Federal and State reimbursement initiatives across the enterprise.
• Works horizontally across reimbursement managers, finance leadership, operational departments, and external stakeholders to advance high-priority programs from strategy through implementation.
• Leads transformational initiatives spanning supplemental payment programs, reimbursement optimization, regulatory change, audit strategy, and the transition of outsourced functions to in-house operations.
• Splits time between director-led enterprise projects and manager-supported operational work, deploying subject matter expertise where complexity, risk, or financial impact is highest.

Primary duties and responsibilities:

• Strategic Partnership & Enterprise Leadership
  • • 1. Serve as strategic partner to the Corporate Director, providing surge capacity and subject matter expertise on high-priority enterprise reimbursement initiatives.
    • 2. Lead cross-functional workgroups spanning finance leadership, operational departments, and external stakeholders to drive complex Federal and State reimbursement projects from strategy through implementation.
    • 3. Develop executive-level summaries, briefing materials, strategic recommendations, and implementation roadmaps to support leadership decision-making.
    • 4. Assist in transition planning for reimbursement functions currently supported by external vendors, managing migration to in-house operations.
• Supplemental Payment Programs & State Reimbursement
  • • 1. Provide subject matter expertise on State Medicaid financing mechanisms, waiver programs, directed payment models, and supplemental funding structures, with emphasis on Georgia Medicaid/DCH policies.
    • 2. Oversee cross-functional workgroups for Disproportionate Share Hospital (DSH) programs, Upper Payment Limit (UPL) reporting, provider tax programs, Graduate Medical Education (GME) funding, and uncompensated care pools.
    • 3. Coordinate data collection, financial modeling, regulatory documentation, and executive reporting tied to state and federally funded reimbursement streams.
    • 4. Support regulatory change implementation and monitor evolving DCH policies and state-specific settlement programs.
• Financial Analysis & Reimbursement Modeling
  • • 1. Conduct financial impact analyses related to new business ventures, service line expansions, provider-based arrangements, and organizational integrations to quantify governmental reimbursement implications.
    • 2. Develop advanced reimbursement models to evaluate the financial impact of regulatory changes, program participation decisions, and optimization opportunities.
    • 3. Support budget development, audit strategy, appeals preparation, and regulatory correspondence.
• Operational Support & Project Management
  • • 1. Split time supporting Government Reimbursement Managers on high-complexity initiatives, operational escalations, and projects with elevated risk or financial impact.
    • 2. Manage multiple complex initiatives simultaneously with a high degree of autonomy, aligning stakeholders, mitigating regulatory risk, and ensuring timely execution.
    • 3. Perform reimbursement impact analysis for new business initiatives and operational changes to inform leadership decisions.
• Additional Duties as Assigned.
• Travel: Less than 10% of the time may be required. Work Type: Remote employee

Minimum Required Qualifications:

• Education - Bachelor's degree in Accounting, Finance, or related field required.
• Experience - Minimum 6 years of governmental reimbursement experience.

Knowledge, skills, and abilities (required): 

• Strong experience with State Medicaid reimbursement programs required. 
• Demonstrated project leadership and cross-functional coordination experience. 
• Advanced analytical and reimbursement modeling skills

Preferred Qualifications:

• Experience in complex academic healthcare systems preferred.
• Experience with EPIC and Strata preferred.

Knowledge, skills, and ability requirements (preferred): 

• Georgia Medicaid/DCH experience strongly preferred.
  PHYSICAL REQUIREMENTS (Medium Max 25lbs): up to 25 lbs., 0-33% of the work day (occasionally) Lifting 25 lbs. max; Carrying of objects up to 25 lbs.; Occasional to frequent standing & walking, Frequent sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
  ENVIRONMENTAL FACTORS: Factors affecting environmental conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure, Bio-hazardous waste chemicals/gases/fumes/vapors, Communicable diseases, Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

ACCOMMODATIONS: EHC will provide reasonable accommodation to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Leave and Accommodations.  

PHYSICAL REQUIREMENTS: (Medium-Heavy) 36-75 lbs., 0-33% of the work day (occasionally); 20-35 lbs., 34-66% of the workday; (frequently); 10-20 lbs., 67-100% of the workday (constantly); Lifting 75 lbs. max; Carrying of objects up to 35 lbs.; Occasional to frequent standing & walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks. 
 
ENVIRONMENTAL FACTORS: Factors affecting environmental conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks.