Pricing Analyst - Revenue Integrity

Your job is more than a job

Under the general direction of the Senior Director of Revenue Integrity, the Pricing Analyst
is responsible for collecting, analyzing, and monitoring the organization’s pricing, cost, and budget data to positively impact financial performance and outcomes. The Analyst will need to utilize a variety of analytical methods, tools, models and techniques, as well as to translate government requirements to evaluate complex requests or situations.

Your Everyday

• Assist with annual rates and establishment processes for both hospital and professional charging /billing, for LCMC Health, including but not limited to:
  • Obtaining benchmarking data, volumes, reimbursement, and other information required to complete annual fee reviews to ensure pricing remains current and competitive
  • Compile data
  • Reporting as needed

• Assist with annual CPT code change process for both hospital and professional billing, for LCMC Health, including but not limited to:
  • Communication with various stakeholder groups such as Revenue Cycle Leaders, CDM Coordinators, Coding, Contracting, Reimbursement Managers, Revenue Cycle Directors, IT, etc.
  • Compile data
  • Reporting as needed
• Conduct detailed analysis of internal cost data, revenue, and payer contracts to evaluate pricing accuracy and financial impact.
• Monitor market trends, including competitor pricing and reimbursement patterns, to ensure the hospital's prices are aligned with industry standards.
• Identify opportunities for optimizing pricing structures to enhance revenue capture and improve profitability.
• Provide recommendations to leadership on potential adjustments to pricing models that could lead to increased revenue or reduced costs.
• Utilize knowledge of the healthcare industry, clinical and/or business workflows to propose data driven solutions and improvements while working collaboratively with various stakeholders
• Ensure that pricing strategies comply with federal, state, and local regulations, including those set by Medicare, Medicaid, and other third-party payers.
• Maintain current knowledge of regulatory requirements impacting hospital pricing, including transparency laws, billing regulations, and payer guidelines.
• Work closely with revenue cycle, billing, and finance departments to ensure pricing models align with reimbursement structures and maximize profitability.
• Coordinate with coding and charge capture teams to ensure that pricing reflects accurate service delivery and coding practices.
• Develop financial models to assess the impact of pricing changes on hospital revenue and overall financial performance.
• Utilize these models to project future pricing trends, helping leadership make informed decisions about adjustments or enhancements to pricing structures.
• Utilize SQL and other query tools to analyze large quantities of data, from multiple complex internal and external sources to glean understanding, derive actionable insights into organizational performance and the external environment, and measure progress toward strategic initiatives
• Prepare detailed reports and presentations on pricing strategies, market analysis, and financial impact to share with leadership and other stakeholders.
• Present findings and recommendations based on data analysis to executive teams for decision-making purposes.
• Participates in efforts to review and analyze the chargemaster (CDM) to ensure consistency with industry standards and to ensure that change in pricing, CPT/HCPCS codes, and revenue codes are accurate and compliant with billing regulations
• Continuously monitor and evaluate the effectiveness of current pricing strategies and models, adjusting as necessary to respond to market conditions, regulatory changes, or financial goals.
• Develop, produce, validate, and distribute standard charge-related reports and ad-hoc reports as needed
• Works hand in hand with CDM Team for pricing of all chargemaster items

The Must-Haves

Minimum:

EXPERIENCE QUALIFICATIONS:

• High School Diploma and six (6) years of experience in accounting, finance or analytics that includes experience with computer systems, spreadsheet and database applications, data reporting and interpretation
• Bachelor’s degree and two (2) years of experience in accounting, finance or analytics that includes experience with computer systems, spreadsheet and database applications, data reporting and interpretation
• Preferred – Four (4) years of experience in accounting, finance or analytics that includes experience with computer systems, spreadsheet and database applications, data reporting and interpretation, as well as experience using Epic Clarity, SQL, and Epic Chronicles in a healthcare or business administration setting

EDUCATION QUALIFICATIONS:

• Required – HS Diploma
• Preferred - Bachelor’s degree in accounting, Finance, Business, Healthcare, Analytics or another related field, or Master’s degree in accounting, Finance, Business, Healthcare, Analytics or another related field.

LICENSES AND CERTIFICATIONS:

• Preferred: Epic Certification in any area, CPA

SKILLS AND ABILITIES:

• Advanced financial and analytical skills:
  • Knowledge of Generally Accepted Accounting Principles (GAAP) and governmental regulations as applied to health care financial management
  • Knowledge of SQL, Clarity, and/or other analytical reporting tools
  • Demonstrates professional standards surrounding data access, security, sensitivity, and confidentiality
  •  Ability to analyze data and workflows to identify complex problems and issues to recommend solutions
  • Ability to make good judgments in demanding situations
• Advanced leadership skills.
  • Advanced communication skills both written and verbal
  • Ability to develop goals, objectives, and establish priorities
  • Ability to implement change in a positive, sensitive, and forward-thinking
  • manner
  • Inspire confidence, good judgment, and the ability to act decisively at the
  • right time
  • Self-starter with a willingness to try new ideas
  • Positive, can-do attitude coupled with a sense of urgency
• Advanced technical skills:
  • Thorough knowledge and experience in financial system applications and software
  • Experience in database development and management
  • Experience in Microsoft Office Suite (Excel, Access, Word, Outlook, and
  • Power Point)
  • Experience using Epic EHR applications
  • Knowledge of maintain and auditing the chargemaster (CDM)
• Strong customer service and human relations abilities
  • Ability to effect collaborative alliances and promote teamwork
  • Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders
  • Ability to network with Revenue Cycle/Integrity leaders from other organizations 

WORK SHIFT:

LCMC Health is a community. 

Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary

Your extras

• Deliver healthcare with heart. 
• Give people a reason to smile. 
• Put a little love in your work. 
• Be honest and real, but with compassion.  
• Bring some lagniappe into everything you do. 
• Forget one-size-fits-all, think one-of-a-kind care. 
• See opportunities, not problems – it’s all about perspective. 
• Cheerlead ideas, differences, and each other. 
• Love what makes you, you - because we do

You are welcome here. 

LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.

The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities.  LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.

Simple things make the difference. 

1.    To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information. 

2.    To ensure quality care and service, we may use information on your application to verify your previous employment and background.  

3.    To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed. 

4.    To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.