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Welcome to CommonSpirit Careers

The power of humankindness works here

Reimbursement Analyst

  • Baylor St Luke's Medical Group
  • Houston, Texas, Remote
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About Us

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 138 hospital-based locations, in addition to its home-based services and virtual care offerings.

Our Mission

As CommonSpirit Health, we make the healing presence of God known in our world by improving the health of the people we serve, especially those who are vulnerable, while we advance social justice for all. To learn more about a calling that defines and unites, please click here for more information about our mission, vision, and values.

The posted compensation range of $18.96 - $26.78 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Job ID
2026-457792
Employment Type
Full Time
Department
Finance
Hours/Pay Period
80
Weekly Schedule
Monday - Friday (8:00 am - 5:00 pm
Shift
Day
Remote
Yes
Category
Accounting and Finance

Job Summary and Responsibilities

This job is responsible for the use of a system tool (currently Experian) to monitor, track, appeal and manage findings along with the denial team and payer strategies specific to underpayments from insurance companies.  The incumbent will discern trends in complex streams of data and will find/seek solutions to issues affecting denials and/or reimbursement, inclusive of directly appealing to all payers for the purpose of recovering monies owed.  

Work also includes:  1) interpreting report findings and taking course of appeal or escalation as needed; 2) providing data for the denial manager as needed for management of AR and Denials that is revealed in findings utilizing Experian tool; 3) works with RCM Analyst and payer strategies to appeal appropriately and escalate effectively as needed to recover monies  4) works with finance and other stakeholders as needed for underpayments and is able to summarize and present data/findings in succinct and efficient manner.

Work requires mastery of the Microsoft Office Suite (Excel, Outlook, PowerPoint), Experian and RCM billing system used.  Strong analytical and critical thinking skills are required for timely report generation through use of computer-based applications and data.  Knowledge and practice of denial management, insurance follow up and payer contracts as provided to them.  Requires ability to present data in succinct manner so other stakeholders can understand and assist in escalations.  Strong knowledge of insurance, denials and performing appeals.

Designs, develops and tests reports to facilitate efficient data extraction and management of underpayments; develops and maintains timely and accurate documentation related to development, reporting and analytical activities to appeal.  
Learns to run reports out of a system utilized for monitoring contract payments (Experian), import to excel and create summary data for trends and analysis.  Also able to run and manipulate data to appeal effectively with payers.
Provides management with weekly, monthly, quarterly, and annual updates/summaries for trends to decrease denials as tool allows as well as tracking underpayment data, payers and monies owed and recovered.

Monitors ad hoc reporting requests using Experian and/or billing system and responds to/fulfill requests within predetermined service timeframes.
Assists in gathering information for various financial projects, including payer contract negotiations, payment variance analysis, and reimbursement analysis; runs ad hoc reports as needed; performs in-depth analysis with tool; is able to summarize results and performs appeals/engage payers directly. 
Ensures that relevant changes are fully understood and that current data/reports are updated to ensure timely and accurate information is accessible and produced.  
Identifies, researches and resolves (within position scope) unusual, complex or escalated issues through critical thinking and problem solving skills; notifies Denial Supervisor/Denial Manager/RCM Director of ongoing issues and concerns.
Performs appeals with insurance companies for underpayments and denials utilizing either billing or contract manager system as needed.
Works directly with payers, performs appeals, attends JOC calls, collaborates directly with payer strategies to recover all monies owed.
Monitors weekly performance metrics and completes root cause analyses to identify improvement opportunities related to denial activities and provides this information for Denial manager to use.
Applies a test of reasonableness to question results of each analysis before the task/analysis is complete, appeals are made and/or escalation to JOC calls and payer strategies.
Documents processes as well as source information and calculations used in financial analyses.
Communicates technical changes/suggestions to RCM leaders. 
Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function; maintains confidentiality of medical records and related data.
Has knowledge of, and is compliant with, government regulations including "signature on file" requirements,   compliance program, HIPAA, etc.
Establishes and maintains professional and effective relationships with peers and other stakeholders.
Works collaboratively with Revenue Cycle team members and other stakeholders to meet expectations and deliverable timelines.  
Establishes and maintains a professional relationship with all RCM, Payer Strategies and Finance staff locally and within other markets we serve in order to resolve issues. 
Promotes an atmosphere of collaboration so Revenue Cycle team members feel comfortable approaching issues and challenges.
Depending on the role, may be called upon to support other areas in the Revenue Cycle.
Performs related duties as required.


Job Requirements

Required Education
High School Diploma
Associates degree Preferred
Required Education 
5 years experience in Insurance Follow Up/Denials, 3 years experience in data analysis

Equivalent combination of education and experience which provides the required knowledge, skills and abilities to perform the essential functions of the position.

Where You'll Work

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. & from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Total Rewards

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit our Total Rewards

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.

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CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.