H-1B Visa Reimbursement Analyst Jobs
Reimbursement Analysts who decode payer contracts, manage claims adjudication, and navigate third-party billing workflows qualify as H-1B specialty occupation workers. Employers in health systems, revenue cycle management firms, and insurance organizations sponsor H-1B petitions for this role, with the 85,000-slot annual cap making early registration critical.
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Get Access To All JobsResponsibilities/Job Description:
Provide analysis and demonstrate understanding of pharmacy revenue cycle management to optimize the payment cycle for retail, specialty, compounding, and long-term care pharmacy claims. Ensure maintenance and understanding of the overall workflow of pharmacy accounts. Review payments for accuracy, ensure collection according to contracts, understand and follow-up with insurance companies to leverage the revenue process. Utilize preferred collection procedures to obtain third party payments and ensure compliance with Fairview Pharmacy Services (FPS) and Fairview Health Services (FHS) payer contracts. Ensure accuracy of FPS' secondary billing processes and related vendor data feeds into FPS systems as required. Advocate on behalf of FPS to ensure the most efficient processes regarding claim resolution. Evaluate denials, short-pays and rejections. Provide proactive and ongoing follow-up and problem solving with insurance companies and pharmacy sites to identify trends, communicate proactively, and ensure accuracy in the process. Contribute to scalable process improvement to advance external revenue from the national strategy platform with pharmacy business office services.
Responsibilities
- Understand the overall workflow to proactively solve problems, provide analysis and evaluate trends in the revenue cycle.
- Demonstrates analytical skills including the ability to reconcile payer remittances.
- Understands the payer denials and impact on FPS revenue cycle and overall margins.
- Displays initiative to resolve 835 remittance issues including but not limited to; unapplied cash, claim exceptions and partial pays.
- Evaluates contracts, analyzes payments and proactively problem solves to optimize the pharmacy claim payment cycle.
- Provides claims resolution to ensure accuracy in the process.
- Proactively communicates with pharmacy site staff, revenue integrity operations staff, and insurance companies (both pharmacy benefit managers and health plans) to escalate and resolve claims payment discrepancies.
- Analyzes existing reimbursement arrangements/networks and reimbursement and operational issues with claims systems and their subsequent impact on financial results.
- Understand contracts to achieve results and department metrics; including but not limited to:
- Payer Days Service Outstanding (DSO) equals or exceeds department goals
- Open Accounts Receivable % aged greater than 60 days meets or exceeds department goals
- Ensures timely submission of secondary payer billing which meets or exceeds department goals.
- Ensures applied cash targets are met for assigned payers.
- Review payment for accuracy, ensure collection according to contracts, understand and follow-up with insurance payers (both pharmacy benefit managers and health plans) to leverage the pharmacy revenue cycle process.
- Utilizes preferred collection procedures to obtain third party payments and ensures compliance with Fairview Pharmacy Services and Fairview Health Services payer contracts.
- Ensures accuracy of FPS’ secondary billing processes and related vendor data feeds into FPS systems as required.
- Understands regulatory, HMO, PPO, Federal, State and other third party payer requirements needed to prepare and or process claims.
- Ensure optimal revenue cycle performance through evaluation, analysis and problem solving.
- Uses data for projections as part of contractual analysis.
- Completes detailed financial impact analysis of provider rate.
- Produces reports for payment variances, rejected, denied and partial pay claims.
- Reviews aging reports that have reached certain aged categories (30, 60, 90 days, etc).
- Generates manual and on-line billing for resubmission for third party payer’s outstanding balances.
- Reviews payment process for accuracy; provides necessary follow-up.
- Communicates and resolves reimbursement issues to coordinate payer/provider relations between payers and Fairview Pharmacy Services.
- Identifies and communicates trends to PBO leadership to improve overall pharmacy revenue cycle performance.
- Provides analysis to stakeholders with explanations of reimbursement findings from assigned providers utilizing Excel and displays initiative to assist in identifying potential compliance issues to FPS staff and makes recommendations to Finance management for resolution.
- Constantly analyzes operations, and attempts to improve processes in order to provide better customer service and improve the pharmacy revenue cycle (including minimizing controllable loss categories, i.e. Timely Filing).
- Attend periodic meetings with payer representatives to discuss discrepancies and assist in developing action plan for correction.
- Contribute to scalable process improvement to advance external revenue from the national strategy platform with pharmacy business office services.
- Provides retail, specialty, compounding and long-term care pharmacy revenue cycle insights to venture partner teams and PBO vendors to assist with product/service improvement.
- Collaborates with PBO leadership team to assist in the development of new process capabilities to improve efficiency, scalability and margin for FPS.
- Uses problem solving and critical thinking to evaluate to identify, define, analyze and resolve work problems through investigation of alternative ideas and approaches.
Required Qualifications
- B.S./B.A. in Business, healthcare or related field or equivalent combination of education and related experience
- 3 years healthcare reimbursement analysis, collection experience, revenue cycle process knowledge experience and/or pharmacy insurance experience
- This individual should have strong interest in learning new IS systems (Enterprise Rx, RMS StarLink, Frameworks LTC, Epic, Inmar, etc) as well as the ability to work independently
- Excellent customer service skills, proficient in English language, capable of solving problems effectively, ability to follow policies and procedures, and competent mathematical skills
- Strong critical thinking and analytical skills
- Ability to work independently and exercise independent judgment
- Ability to prioritize and deal with fluctuation in workload
- Good computer and telephone skills
Preferred Qualifications
- 5 years pharmacy reimbursement analysis and collection experience with Medicare, Medicaid, Pharmacy Benefit Manager and Commercial Health Plan payer experience
- Pharmacy dispensing knowledge and/or experience
- Pharmacy experience in infusion therapies, retail, specialty and/or hospital setting
- Knowledge of third party payers, billing procedures and insurance
- Pharmacy Technician MN
Qualifications
$28.71 - $40.54 Hourly
Responsibilities/Job Description:
Provide analysis and demonstrate understanding of pharmacy revenue cycle management to optimize the payment cycle for retail, specialty, compounding, and long-term care pharmacy claims. Ensure maintenance and understanding of the overall workflow of pharmacy accounts. Review payments for accuracy, ensure collection according to contracts, understand and follow-up with insurance companies to leverage the revenue process. Utilize preferred collection procedures to obtain third party payments and ensure compliance with Fairview Pharmacy Services (FPS) and Fairview Health Services (FHS) payer contracts. Ensure accuracy of FPS' secondary billing processes and related vendor data feeds into FPS systems as required. Advocate on behalf of FPS to ensure the most efficient processes regarding claim resolution. Evaluate denials, short-pays and rejections. Provide proactive and ongoing follow-up and problem solving with insurance companies and pharmacy sites to identify trends, communicate proactively, and ensure accuracy in the process. Contribute to scalable process improvement to advance external revenue from the national strategy platform with pharmacy business office services.
Responsibilities
- Understand the overall workflow to proactively solve problems, provide analysis and evaluate trends in the revenue cycle.
- Demonstrates analytical skills including the ability to reconcile payer remittances.
- Understands the payer denials and impact on FPS revenue cycle and overall margins.
- Displays initiative to resolve 835 remittance issues including but not limited to; unapplied cash, claim exceptions and partial pays.
- Evaluates contracts, analyzes payments and proactively problem solves to optimize the pharmacy claim payment cycle.
- Provides claims resolution to ensure accuracy in the process.
- Proactively communicates with pharmacy site staff, revenue integrity operations staff, and insurance companies (both pharmacy benefit managers and health plans) to escalate and resolve claims payment discrepancies.
- Analyzes existing reimbursement arrangements/networks and reimbursement and operational issues with claims systems and their subsequent impact on financial results.
- Understand contracts to achieve results and department metrics; including but not limited to:
- Payer Days Service Outstanding (DSO) equals or exceeds department goals
- Open Accounts Receivable % aged greater than 60 days meets or exceeds department goals
- Ensures timely submission of secondary payer billing which meets or exceeds department goals.
- Ensures applied cash targets are met for assigned payers.
- Review payment for accuracy, ensure collection according to contracts, understand and follow-up with insurance payers (both pharmacy benefit managers and health plans) to leverage the pharmacy revenue cycle process.
- Utilizes preferred collection procedures to obtain third party payments and ensures compliance with Fairview Pharmacy Services and Fairview Health Services payer contracts.
- Ensures accuracy of FPS’ secondary billing processes and related vendor data feeds into FPS systems as required.
- Understands regulatory, HMO, PPO, Federal, State and other third party payer requirements needed to prepare and or process claims.
- Ensure optimal revenue cycle performance through evaluation, analysis and problem solving.
- Uses data for projections as part of contractual analysis.
- Completes detailed financial impact analysis of provider rate.
- Produces reports for payment variances, rejected, denied and partial pay claims.
- Reviews aging reports that have reached certain aged categories (30, 60, 90 days, etc).
- Generates manual and on-line billing for resubmission for third party payer’s outstanding balances.
- Reviews payment process for accuracy; provides necessary follow-up.
- Communicates and resolves reimbursement issues to coordinate payer/provider relations between payers and Fairview Pharmacy Services.
- Identifies and communicates trends to PBO leadership to improve overall pharmacy revenue cycle performance.
- Provides analysis to stakeholders with explanations of reimbursement findings from assigned providers utilizing Excel and displays initiative to assist in identifying potential compliance issues to FPS staff and makes recommendations to Finance management for resolution.
- Constantly analyzes operations, and attempts to improve processes in order to provide better customer service and improve the pharmacy revenue cycle (including minimizing controllable loss categories, i.e. Timely Filing).
- Attend periodic meetings with payer representatives to discuss discrepancies and assist in developing action plan for correction.
- Contribute to scalable process improvement to advance external revenue from the national strategy platform with pharmacy business office services.
- Provides retail, specialty, compounding and long-term care pharmacy revenue cycle insights to venture partner teams and PBO vendors to assist with product/service improvement.
- Collaborates with PBO leadership team to assist in the development of new process capabilities to improve efficiency, scalability and margin for FPS.
- Uses problem solving and critical thinking to evaluate to identify, define, analyze and resolve work problems through investigation of alternative ideas and approaches.
Required Qualifications
- B.S./B.A. in Business, healthcare or related field or equivalent combination of education and related experience
- 3 years healthcare reimbursement analysis, collection experience, revenue cycle process knowledge experience and/or pharmacy insurance experience
- This individual should have strong interest in learning new IS systems (Enterprise Rx, RMS StarLink, Frameworks LTC, Epic, Inmar, etc) as well as the ability to work independently
- Excellent customer service skills, proficient in English language, capable of solving problems effectively, ability to follow policies and procedures, and competent mathematical skills
- Strong critical thinking and analytical skills
- Ability to work independently and exercise independent judgment
- Ability to prioritize and deal with fluctuation in workload
- Good computer and telephone skills
Preferred Qualifications
- 5 years pharmacy reimbursement analysis and collection experience with Medicare, Medicaid, Pharmacy Benefit Manager and Commercial Health Plan payer experience
- Pharmacy dispensing knowledge and/or experience
- Pharmacy experience in infusion therapies, retail, specialty and/or hospital setting
- Knowledge of third party payers, billing procedures and insurance
- Pharmacy Technician MN
Qualifications
$28.71 - $40.54 Hourly
See all Reimbursement Analyst jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Reimbursement Analyst roles.
Get Access To All JobsTips for Finding H-1B Visa Sponsorship as a Reimbursement Analyst
Map your degree to the SOC code
USCIS evaluates specialty occupation using your degree field against the role's requirements. A finance, health information management, or accounting degree maps cleanly to Reimbursement Analyst positions. A mismatched degree triggers RFEs, so document the connection before applying.
Target revenue cycle management employers first
Large hospital systems and dedicated revenue cycle firms file LCAs consistently for billing and reimbursement roles. Search DOL's OFLC LCA disclosure data to confirm which employers have certified Reimbursement Analyst positions before investing time in the application process.
Use Migrate Mate to filter verified sponsors
Pull up Reimbursement Analyst listings on Migrate Mate to see employers with confirmed H-1B LCA filing history for this role. That filters out postings where sponsorship is listed as possible but the employer has no documented track record.
Confirm the prevailing wage tier before negotiating
Your employer's LCA must certify a wage meeting DOL's prevailing wage for your geographic area. Run the OFLC Wage Search for the Reimbursement Analyst SOC code at the job's location before your offer discussion so you know the floor your employer is legally required to meet.
Register in March and plan for cap-gap coverage
H-1B registration opens each March for the following October start. If you're on F-1 OPT, cap-gap protection extends your work authorization automatically through September 30 if your petition is selected and timely filed. Confirm your OPT end date aligns with this window.
Request premium processing for billing-cycle critical roles
Healthcare employers often need Reimbursement Analysts in place before fiscal year transitions or payer contract renewals. Ask your employer to file with USCIS premium processing, which reduces adjudication time to 15 business days and gives both parties a predictable start date.
Reimbursement Analyst jobs are hiring across the US. Find yours.
Find Reimbursement Analyst JobsReimbursement Analyst H-1B Visa: Frequently Asked Questions
Does a Reimbursement Analyst role qualify as an H-1B specialty occupation?
Yes. Reimbursement Analyst positions typically require at least a bachelor's degree in finance, health information management, accounting, or a related field, which meets USCIS's specialty occupation standard. The key is that the employer's job description specifies a degree requirement in a directly related field rather than treating the degree as optional.
Which types of employers sponsor H-1B visas for Reimbursement Analyst jobs?
Hospital systems, academic medical centers, revenue cycle management companies, and large insurance organizations are the most consistent H-1B sponsors for this role. You can verify filing history using DOL's LCA disclosure data before applying. Migrate Mate surfaces employers with confirmed sponsorship history for Reimbursement Analyst positions, so you can prioritize outreach accordingly.
How does the prevailing wage requirement affect Reimbursement Analyst H-1B filings?
Your employer must certify through a Labor Condition Application that your offered wage meets or exceeds the DOL prevailing wage for the Reimbursement Analyst occupation in your work location. The wage level, from Level I to Level IV, reflects experience and supervisory responsibility. Use the OFLC Wage Search to look up the applicable wage before finalizing your offer.
Can I transfer my H-1B to a new Reimbursement Analyst role at a different employer?
Yes. H-1B portability under AC21 lets you start working for a new employer as soon as the transfer petition is filed with USCIS, as long as your current H-1B has been approved for at least 180 days. Your new employer files a new I-129, and you don't need to restart the cap process since you're already cap-subject.
What documentation strengthens an H-1B petition for a Reimbursement Analyst position?
The employer needs to show the role genuinely requires a specific bachelor's degree, not just any degree. Supporting documents include the job description specifying degree requirements, the O*NET occupation profile for the relevant SOC code, and evidence of the employer's normal hiring practices for comparable positions. A credential evaluation is useful if your degree is from outside the U.S.
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