Institutional Reimbursement Analyst II

About the role

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years , we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

About the Role

Resolve process inquiries initiated by hospitals and ancillary providers. May also perform necessary tasks on-site.

What You'll Do

Responsibilities:

Review and compile monthly, quarterly, and annual reports on quality statistics in order to provide recommendations for process improvement and best practices.

Partner with facility employees to identify and bridge financial gaps, i.e.; resolving open Accounts Receivables (ARs), claim payment issues, etc.

Participate in regular internal /external meetings for purposes of calibrations, trends, best practice sharing, identify process improvements, and streamline claims processes.

Perform other related tasks as assigned by management.

What You Bring

Education/Experience:

High School Diploma/GED required

Requires a minimum of two to four (2-4) years experience in the healthcare industry.

Knowledge/Skills:

Requires experience with facility reimbursements.

Claims processing experience required.

BlueCard experience strongly preferred.

Strong Customer Service skills.

Strong PC skills.

Analytical Thinking, Critical Thinking, Organizational Skills and strong Written Communication Skills.

Why Horizon?

At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we’d love to hear from you!

Salary Range:

$56,200 - $75,285

​This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

Comprehensive health benefits (Medical/Dental/Vision)

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Disclaimer:

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

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. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

Posting text as published by Bcbsnj.

The evidence behind this listing

Workplace

Remote Matched in posting text

Seniority

Not established

Employment type

full time

Location as listed

Newark, NJ - Remote, United States of America

Pay and work authorization

Stated pay

Not stated

Visa sponsorship

Not stated

Security clearance

Not established

Citizenship

Not established