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Senior Contract Reimbursement Analyst at Horizon Blue Cross Blue Shield of New Jersey

Posted in Other 30+ days ago.

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Type: Full Time
Location: Hopewell, New Jersey

Job Description:

Job Summary:

This position is responsible the daily support and administration of reimbursement system(s) for participating acute care physicians, hospitals and ancillary institutional providers. Additional duties include analysis, problem solving, handling of system specifications and acting as a liaison to other divisions.


* Perform and assist with quantitative and qualitative analysis to detect system problems and recommend viable solution, interim alternatives and documentation of processing irregularities.

* Review claim payments to ensure contract implementation are correct.

* Monitor assigned tasks to ensure meeting of implementation dates, quality, operational effectiveness and adherence to policy and standards.

* Performs other duties as required by management.


* Requires a bachelor's degree in Finance or Accounting from an accredited college or university, preferably with additional certification in computer science or equivalent work experience.

* Prefers a minimum of three (3) years professional experience in financial analysis and data reporting, health related auditing and or accounting in a health care environment.


* Requires knowledge of generally accepted accounting principles, cost analysis and auditing principles.

* Requires knowledge of Horizon BCBSNJ health products and services.

* Requires knowledge of health contracts.

* Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, Access, PowerPoint) and Lotus Notes. Should be knowledgeable in the use of intranet and internet applications.

* Knowledge of intermediate Access and SAS Enterprise Guide preferred.

Skills and Abilities:

* Must have effective verbal and written communication skills and demonstrate the ability to work well within a team. Demonstrated ability to deliver highly technical information to less technical individuals.

* Must demonstrate professional and ethical business practices, adherence to company standards, and a commitment to personal and professional development.

* Proven time management skills are necessary.

* Proven ability to exercise sound judgment and strong problem solving skills.

* Must be client service focused with effective ability to empathize.

* Must be detail oriented with strong organizational and data processing skills. Proven ability to follow detailed instructions is essential, along with proven problem solving skills.

* Proven analytical, research and problem solving skills a must.

* Must demonstrate the ability to learn quickly and apply learning to new situations. Must exhibit flexibility to change as appropriate.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law.



Job Level
Individual Contributor

--Horizon NJ Health

Job Type
Full Time

Hopewell, NJ