Reimbursement Analyst

Overview

The organization is seeking a full-time Reimbursement Analyst for the Enterprise Corporate - Reimbursement department.

• Status: Full time (benefits eligible)
• Hours per week: 40
• Work arrangement: Fully remote from AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.
• Remote restrictions: Remote work is NOT permitted for short or long periods in CA, CO, CT, HI, MA, MD, MN, NJ, NY, OR, RI, VT, WA and working Internationally (including working while on vacation).
• Travel: This position requires travel and exposure to weather and road conditions.
• Relocation/visa: No relocation. No sponsorship or transfer of visa for this position now or in the future.

Pay Range

• $33.05 - $49.60

Responsibilities

• Assist with plans and prepare revenue analysis for system-wide programs, projects, and services; monitor revenue budgets and benchmarking activities.
• Support system intermediary data requests, audits, and exit conferences.
• Assist with preparation of information required for system-wide external financial audits, and Medicare and Medicaid interim and year-end cost reports.
• Coordinate the year-end system financial audit with external auditors and reimbursement staff; develop and maintain relationships with the fiscal intermediary and external auditors.
• Analyze information and make recommendations to ensure regulatory reviews are completed accurately and on time.
• Participate in 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 provide recommendations to ensure optimal reimbursement; understand and oversee tools used for calculations.
• Develop and coordinate system-wide monthly closing processes related to Medicare/Medicaid liabilities and allowances on patient receivables.
• Monitor processes to ensure accurate payment for Medicare/Medicaid; 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 related to current and proposed reimbursement; work with Government Affairs and external consultants to provide needed expertise.
• Coordinate with Financial Planning departments for system budgets related to third-party reimbursement.
• Support Financial Planning with retrospective financial review and pro forma development.

Requirements

Education

• Bachelor’s degree in Finance or related field.

Experience

• Typically requires 3 years of experience in reimbursement, including experience preparing Medicare/Medicaid cost reports, regulations and analysis, modeling and reporting of 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 the interrelationship of financial statements to ensure compliance and maximize reimbursement through strategies amid ongoing changes.
• Strong initiative; able to perform tasks independently and produce high-quality analytical results.
• Strong accounting background with experience preparing and/or reviewing health care financial statements for accurate account analysis.
• Proficiency in Microsoft Office (Excel, PowerPoint, Word, Access) and software systems/data management tools (or similar products).
• Proficiency in data mining and analysis.
• Ability to function 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; capable of carrying projects through to successful completion.

Preferred Qualifications

• Advanced Excel skills
• Accounting skills
• Healthcare experience
• PowerBI experience
• Analytic tools in Epic; Slicer/Dicer and/or Reporting Workbench
• Accounts receivable experience
• Ledger entry experience

Compensation & Benefits

• Paid Time Off programs
• Health and welfare benefits including 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 benefits may depend on FTE or status (e.g., full-time, part-time, per diem, temporary, etc.).

Location / Working Conditions

• Work location: Remote, restricted to eligible states listed above.
• Physical requirements:
  • 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.
• Working environment: Exposed to a normal office environment.
• Travel: Required; exposure to weather and road conditions.

Other

• No licensure, registration, and/or certification required.
• This job description outlines general duties and may not include all responsibilities; additional related duties may be assigned.