OPT Reimbursement Specialist Jobs
Reimbursement Specialist roles fall under healthcare administration, a field with steady OPT sponsorship activity. Employers filing Labor Condition Applications for this title typically require a degree in health information management, business, or a related field. Your 12-month OPT window, or 24-month STEM extension if eligible, gives you enough runway to establish yourself with a sponsoring employer.
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Get Access To All JobsSUMMARY
Under general direction, the Senior Contracting and Reimbursement Analyst supports the negotiation, analysis, administration, and financial evaluation of hospital and physician value-based payor agreements. The role combines value-based contracting expertise and net revenue analysis. The role ensures value-based contracts are financially sound, operationally executable, compliant with governmental requirements, and aligned with the system’s strategy. The incumbent evaluates new and existing arrangements, including value-based and alternative payment models; prepares reimbursement analyses, cost report support, net revenue estimates, and financial forecasts; coordinates contract implementation and audit activities. Serves as a liaison among affiliates, finance, analytics, operations, and clinical stakeholders.
Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers, and one another.
In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:
- Instill Trust and Value Differences
- Patient and Community Focus and Collaborate
PRINCIPAL DUTIES AND RESPONSIBILITIES
Value-based Contract Negotiation and Administration
- Assists with payor relations and contracting leadership with hospital and physician negotiations.
- Evaluates new and existing value-based arrangements, bundled payment models, shared savings agreements, and other alternative payment models.
- Assists in coordination of timely contract execution, renewal, renegotiation, amendment, implementation, and distribution of relevant contract materials.
- Prepares and distributes value-based variance analyses, rate matrices, executive summaries, contract abstracts, and other documentation required to communicate financial and operational terms to affected parties.
- Acts as a liaison to health plans, system affiliates, physician organizations, finance, operations, legal, analytics, and other stakeholders regarding contract terms, implementation, and issue resolution.
Reimbursement, Net Revenue, and Financial Analysis
- Prepares and analyzes financial and statistical data required for governmental and third-party reimbursement reporting, affiliate and consolidated cost reports, net revenue schedules, month-end close, budgeting, forecasting, and settlement estimates.
- Analyzes reimbursement methodologies, contract rates, payment terms, rate calculations, final settlements, pass-through payments, advance payments, and payer remittances to identify underpayments, overpayments, financial risk, and opportunities for improvement.
- Quantifies estimated reimbursement from governmental and commercial payors and supports balance sheet and income statement adjustments for liabilities and receivables related to third-party settlements.
- Works closely with analytics and finance leadership to evaluate contract profitability, model financial impacts, monitor performance against contract terms, and develop methodologies to measure reimbursement changes.
- Prices governmental and third-party reimbursement for new or expanded clinical programs and coordinates financial studies related to new programs, product lines, service expansion, and contracting opportunities.
- Participates in development of the annual net revenue operating budget and related forecasts.
Regulatory, Audit, and Compliance Support
- Maintains current knowledge of commercial payor requirements and governmental reimbursement regulations and analyzes their financial, contractual, reporting, and operational impact.
- Prepares and assembles financial and statistical reports required by governmental agencies, third-party payors, auditors, and external advisors.
- Coordinates and supports third-party reimbursement and contract audits, responds to inquiries, assesses proposed audit adjustments, and communicates material issues to leadership.
- Recommends and develops analyses and action plans for appeals, disputes, payment variances, or other matters involving third-party and governmental payors.
- Supports contract and reimbursement quality assurance, audit readiness, internal controls, and compliance with established policies and procedures.
Performs other duties as assigned.
Education
Bachelor's degree in accounting, finance, business, health care administration, or a related field, or equivalent education and experience.
Comprehensive knowledge of health care finance, reimbursement, managed care contracting, contract administration, accounting principles, net revenue, cost reporting, and financial analysis.
Knowledge of hospital and physician payment methodologies, capitation, risk arrangements, value-based contracting, alternative payment models, and governmental reimbursement principles.
Strong analytical, financial modeling, negotiation, communication, project management, and problem-solving skills.
Ability to interpret complex contractual, financial, regulatory, and operational information and communicate conclusions clearly to varied audiences.
Advanced proficiency with Excel-based financial models and database tools. Experience with Epic, EPSi, PeopleSoft, or comparable integrated financial systems preferred.
Experience
Three to five years of progressively responsible experience in a complex health care environment, with significant experience in managed care contracting, contract analysis and negotiation, third-party reimbursement, net revenue, financial reporting and analysis, budgeting, forecasting, cost reporting, or related areas. Demonstrated ability to work independently and manage multiple complex analytical and contracting priorities is required.
SUPERVISORY RESPONSIBILITY
None.
Pay Range
$78,416.00-$129,355.20
Location
Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903
Work Type
M-F (8:00am-5:00pm)
Work Shift
Day
Daily Hours
8 hours
Driving Required
No
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.
SUMMARY
Under general direction, the Senior Contracting and Reimbursement Analyst supports the negotiation, analysis, administration, and financial evaluation of hospital and physician value-based payor agreements. The role combines value-based contracting expertise and net revenue analysis. The role ensures value-based contracts are financially sound, operationally executable, compliant with governmental requirements, and aligned with the system’s strategy. The incumbent evaluates new and existing arrangements, including value-based and alternative payment models; prepares reimbursement analyses, cost report support, net revenue estimates, and financial forecasts; coordinates contract implementation and audit activities. Serves as a liaison among affiliates, finance, analytics, operations, and clinical stakeholders.
Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers, and one another.
In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:
- Instill Trust and Value Differences
- Patient and Community Focus and Collaborate
PRINCIPAL DUTIES AND RESPONSIBILITIES
Value-based Contract Negotiation and Administration
- Assists with payor relations and contracting leadership with hospital and physician negotiations.
- Evaluates new and existing value-based arrangements, bundled payment models, shared savings agreements, and other alternative payment models.
- Assists in coordination of timely contract execution, renewal, renegotiation, amendment, implementation, and distribution of relevant contract materials.
- Prepares and distributes value-based variance analyses, rate matrices, executive summaries, contract abstracts, and other documentation required to communicate financial and operational terms to affected parties.
- Acts as a liaison to health plans, system affiliates, physician organizations, finance, operations, legal, analytics, and other stakeholders regarding contract terms, implementation, and issue resolution.
Reimbursement, Net Revenue, and Financial Analysis
- Prepares and analyzes financial and statistical data required for governmental and third-party reimbursement reporting, affiliate and consolidated cost reports, net revenue schedules, month-end close, budgeting, forecasting, and settlement estimates.
- Analyzes reimbursement methodologies, contract rates, payment terms, rate calculations, final settlements, pass-through payments, advance payments, and payer remittances to identify underpayments, overpayments, financial risk, and opportunities for improvement.
- Quantifies estimated reimbursement from governmental and commercial payors and supports balance sheet and income statement adjustments for liabilities and receivables related to third-party settlements.
- Works closely with analytics and finance leadership to evaluate contract profitability, model financial impacts, monitor performance against contract terms, and develop methodologies to measure reimbursement changes.
- Prices governmental and third-party reimbursement for new or expanded clinical programs and coordinates financial studies related to new programs, product lines, service expansion, and contracting opportunities.
- Participates in development of the annual net revenue operating budget and related forecasts.
Regulatory, Audit, and Compliance Support
- Maintains current knowledge of commercial payor requirements and governmental reimbursement regulations and analyzes their financial, contractual, reporting, and operational impact.
- Prepares and assembles financial and statistical reports required by governmental agencies, third-party payors, auditors, and external advisors.
- Coordinates and supports third-party reimbursement and contract audits, responds to inquiries, assesses proposed audit adjustments, and communicates material issues to leadership.
- Recommends and develops analyses and action plans for appeals, disputes, payment variances, or other matters involving third-party and governmental payors.
- Supports contract and reimbursement quality assurance, audit readiness, internal controls, and compliance with established policies and procedures.
Performs other duties as assigned.
Education
Bachelor's degree in accounting, finance, business, health care administration, or a related field, or equivalent education and experience.
Comprehensive knowledge of health care finance, reimbursement, managed care contracting, contract administration, accounting principles, net revenue, cost reporting, and financial analysis.
Knowledge of hospital and physician payment methodologies, capitation, risk arrangements, value-based contracting, alternative payment models, and governmental reimbursement principles.
Strong analytical, financial modeling, negotiation, communication, project management, and problem-solving skills.
Ability to interpret complex contractual, financial, regulatory, and operational information and communicate conclusions clearly to varied audiences.
Advanced proficiency with Excel-based financial models and database tools. Experience with Epic, EPSi, PeopleSoft, or comparable integrated financial systems preferred.
Experience
Three to five years of progressively responsible experience in a complex health care environment, with significant experience in managed care contracting, contract analysis and negotiation, third-party reimbursement, net revenue, financial reporting and analysis, budgeting, forecasting, cost reporting, or related areas. Demonstrated ability to work independently and manage multiple complex analytical and contracting priorities is required.
SUPERVISORY RESPONSIBILITY
None.
Pay Range
$78,416.00-$129,355.20
Location
Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903
Work Type
M-F (8:00am-5:00pm)
Work Shift
Day
Daily Hours
8 hours
Driving Required
No
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.
See all 56+ OPT Reimbursement Specialist Jobs
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Get Access To All JobsTips for Finding OPT Sponsorship as a Reimbursement Specialist
Target healthcare systems over staffing agencies
Large hospital networks and insurance companies are more likely to sponsor H-1B visas after OPT than staffing firms. Focus your search on employers with dedicated HR and immigration support, which signals they have experience sponsoring international employees.
Align your degree field with the job description
Reimbursement Specialist roles typically require a degree in health information management, business administration, or a related field. Make sure your resume clearly connects your academic background to the billing and coding responsibilities listed in each posting.
Pursue coding certifications to strengthen your profile
Credentials like CPC or CCS from AAPC or AHIMA signal technical competence to employers. Certified candidates stand out in a competitive applicant pool and give sponsoring employers more confidence in a long-term employment relationship beyond your OPT period.
Raise OPT status early in the interview process
Disclosing your OPT authorization upfront saves time for both sides. Frame it clearly: you have current work authorization and are seeking an employer willing to support H-1B sponsorship before your OPT expires. Clarity builds trust and filters serious employers faster.
Apply for your STEM extension as early as possible
If your degree qualifies for the 24-month STEM OPT extension, file at least 90 days before your initial OPT expires. The extended timeline gives employers more runway to sponsor you through the H-1B process without a gap in employment.
Research employers' H-1B filing history before applying
Employers who have previously sponsored H-1B visas for similar roles are more likely to do so again. Checking historical Labor Condition Application data helps you prioritize applications toward companies with a demonstrated willingness to support international employees.
Reimbursement Specialist OPT: Frequently Asked Questions
Can I work as a Reimbursement Specialist on OPT?
Yes. If your degree is in health information management, business administration, healthcare administration, or a closely related field, Reimbursement Specialist roles typically qualify as a direct application of that education. Your employer does not need to file any additional paperwork during your OPT period. You work on your OPT EAD card, and sponsorship only becomes relevant when your OPT approaches expiration.
Does a Reimbursement Specialist job qualify for STEM OPT extension?
It depends on your undergraduate degree, not the job title itself. If your degree is in a STEM-designated field such as health informatics or management information systems, you may qualify for the 24-month extension. Business administration degrees sometimes qualify depending on the specific CIP code your school assigned. Confirm your degree's STEM eligibility with your Designated School Official before counting on the extension.
How do I find Reimbursement Specialist employers who sponsor OPT students?
Migrate Mate is built specifically for F-1 OPT students searching for sponsorship-friendly employers. Rather than filtering through general job boards where sponsorship willingness is unclear, Migrate Mate surfaces roles from employers with a track record of supporting international candidates. Browse Reimbursement Specialist listings there to focus your time on opportunities with real sponsorship potential.
What happens to my Reimbursement Specialist job if I lose the H-1B lottery?
If your employer files an H-1B petition on your behalf and you are not selected in the lottery, your OPT EAD and employment authorization expire at their original end date. Some employers will retain you under cap-exempt H-1B routes if they qualify, or explore alternatives like O-1 visa or EB-2 NIW. Having that conversation with your employer well before lottery results are announced gives you the most options.
Is a Reimbursement Specialist role considered a specialty occupation for H-1B purposes?
USCIS evaluates specialty occupation status case by case, but Reimbursement Specialist roles can qualify when the position genuinely requires a bachelor's degree or higher in a specific field such as health information management or healthcare administration. Employers need to document that the job duties require specialized knowledge at the degree level, not just general administrative skills. An immigration attorney can assess whether a specific job description meets the standard.