Reimbursement Analyst

Overview

This full-time role supports enterprise reimbursement and revenue analysis activities within system-wide programs, projects, and services. The schedule is Monday–Friday, 8:00am–5:00pm CST (40 hours/week). The position is remote with the option to join onsite for monthly Wisconsin and Illinois luncheons or as needed.

The employer does not offer relocation for this position and does not provide sponsorship or transfer of visa now or in the future.

Responsibilities

• Assist with planning and preparing system-wide revenue analysis for programs, projects, and services.
• Monitor revenue budgets and perform benchmarking activities.
• Support system intermediary data requests, audits, and exit conferences.
• Prepare and provide required information for completion of system-wide external financial audits and Medicare/Medicaid interim and year-end cost reports.
• Coordinate year-end system financial audit activities with external auditors and reimbursement staff.
• Develop and maintain relationships with the fiscal intermediary and external auditors.
• Analyze information and assist in making recommendations to ensure regulatory reviews are completed accurately and on time.
• Participate in the development and preparation of system-wide budgeting for Gross and Net Patient Revenue to ensure accuracy, timeliness, and compliance with accounting standards.
• Analyze and review monthly accounts receivable valuation and recommend actions to support optimal reimbursement, including understanding and oversight of related calculation tools.
• Develop and coordinate the system-wide monthly closing process related to Medicare/Medicaid liabilities and allowances on patient receivables.
• Monitor processes to ensure accurate Medicare/Medicaid payments; monitor interim payments for accuracy, appropriateness, and potential liability.
• Request adjustments from United Government Services (UGS) and update internal systems.
• Apply knowledge of Medicare and Medicaid regulations for current and proposed reimbursement and provide expertise in collaboration with Government Affairs and external consultants.
• Coordinate with Financial Planning departments on system budgets related to third-party reimbursement.
• Support Financial Planning with retrospective financial review and pro forma development.

Requirements

• No licensure, registration, or certification required.
• Bachelor’s degree in Finance or related field.
• Typically requires 3 years of experience in reimbursement, including experience preparing Medicare/Medicaid cost reports, regulations analysis, modeling, and reporting for third-party payers.

Knowledge, Skills & Abilities

• Demonstrated expertise with Medicare and Medicaid regulations in a health care or federal intermediary setting.
• Knowledge of third-party regulations and their interrelationship with financial statements to support regulatory compliance and maximize reimbursement strategies amid ongoing change.
• Strong initiative; able to perform tasks independently and produce high-quality analytical results.
• Strong accounting background, including experience preparing and/or reviewing health care financial statements required for accurate account analysis.
• Strong proficiency with Microsoft Office (Excel, PowerPoint, Word, Access) and software/data management tools.
• Proficiency in data mining and analysis.
• Ability to work in a complex environment; excellent written and verbal communication skills, including the ability to communicate revenue cycle issues to all levels of the organization.
• Self-motivated and able to carry projects through to successful completion.

Preferred Qualifications

Not specified.

Compensation & Benefits

• Pay range: $33.05 - $49.60 (hourly)
• Benefits eligible: Yes

Benefits and compensation may include:

• Base compensation within the listed pay range based on qualifications, skills, relevant experience, and/or training
• Premium pay such as shift and on call (where applicable)
• Incentive pay for select positions
• Opportunity for annual increases based on performance
• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

Note: Eligibility for programs listed above may depend on FTE or status (e.g., full-time, part-time, per diem, temporary). Ask a Recruiter for more information during an interview.

Location

Remote with the option to join onsite for monthly Wisconsin and Illinois luncheons or as needed. This role requires travel, so exposure to weather and road conditions is expected.

Physical Requirements and Working Conditions

• Must be able to sit the majority of the workday.
• Must be able to lift up to 10 lbs occasionally.
• Operates all equipment necessary to perform the job.
• Exposed to a normal office environment.
• Travel is required, with exposure to weather and road conditions.