Senior Reimbursement Analyst

Overview

The organization is seeking a Senior Reimbursement Analyst to support Medicare and Medicaid reimbursement activities and help ensure accurate, optimal third-party reimbursement. This role is responsible for preparing and analyzing interim and annual Medicare cost reports, monthly contractual allowance and settlement models, reimbursement forecasts, and other reimbursement-related financial analyses.

This position may be remote in the following states: AL, AZ, AR, FL, GA, ID, IN, IA, KS, LA, MS, MO, MT, NC, OH, OK, SC, SD, TN, TX, UT, VA, WY.

Responsibilities

• Medicare Cost Report preparation and maintenance
  • Prepare, analyze, and maintain interim and final Medicare cost reports, supporting documentation, and reimbursement-related analyses to ensure compliance, accuracy, and reimbursement optimization.
  • Maintain and review cost allocation statistics (including square footage, time studies, and other statistical drivers); recommend changes as necessary.
  • Maintain tracking of physician time study documentation to maximize reimbursement.
• Contractual allowances, settlements, and modeling
  • Complete monthly Medicare and Medicaid contractual allowances and third-party settlements.
  • Prepare and update settlement and contractual allowance models to reflect payment changes, cost report impacts, and other relevant data elements.
  • Reconcile balance sheet settlement and contractual allowance accounts, ensuring they reflect all transactions and current estimates.
• Regulatory and reimbursement expertise
  • Serve as a subject matter resource on Medicare and Medicaid regulations, cost reporting, settlement matters, and regulatory reimbursement impacts to support accurate financial reporting and reimbursement optimization.
  • Monitor proposed and final rules, laws, and regulations impacting reimbursement for the hospital and physician practice; prepare analysis of financial impacts.
  • Coordinate and complete regulatory provider enrollment activities, including CMS-855A applications, and other required provider enrollment updates.
  • Attend monthly meetings with the Alliance of Dedicated Cancer Centers.
• Medicaid supplemental programs analysis
  • Monitor impacts of various State Medicaid programs (including the Florida Cancer Hospital Program) to help ensure optimal Medicaid program funding.
  • Estimate non-claim-based Medicaid program revenue and Intergovernmental Transfers (IGTs) to support adequate and optimal Medicaid program funding.
  • Prepare the Low Income Utilization (LIP) annual survey.
• Special reimbursement projects
  • Conduct research and analysis for special reimbursement projects to maximize reimbursement and support strategic decision making.
  • Exercise independent judgment in analyzing reimbursement issues, developing recommendations, and prioritizing work activities; escalate issues with significant financial, regulatory, or organizational risk.
• Collaboration
  • Collaborate cross-functionally with Government Relations, Managed Care, Patient Financial Services, and external auditors and consultants.

Requirements

• Bachelor’s degree in Finance, Accounting, or related field.
• Minimum of five (5) years of experience in a healthcare financial-related field, with hospital reimbursement experience strongly preferred.

Preferred Qualifications

• Three (3) or more years of hospital reimbursement experience.
• Experience with cost-based / PPS-exempt providers and cost report settlements.
• Experience with Medicaid supplemental payment programs (e.g., DSH/LIP, UPL, state directed payments, IGTs).

Compensation & Benefits

• Salary range: $73,424.00 - $111,883.20
• Salary ranges posted represent the expected base pay range for the role. Actual compensation may vary based on location and a variety of job-related factors, including experience, skills, education, and internal equity among Team Members in similar positions.
• Fair and equitable pay practices are a priority, with regular compensation reviews to ensure alignment across the workforce.

Location

Remote within: AL, AZ, AR, FL, GA, ID, IN, IA, KS, LA, MS, MO, MT, NC, OH, OK, SC, SD, TN, TX, UT, VA, WY.

Equal Employment Opportunity & Reasonable Accommodation

• The employer is an Equal Opportunity/Affirmative Action Employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, or protected veteran or disabled status.
• Reasonable accommodation is available for qualified individuals with disabilities. Requests for accommodation should be made as part of the application or interview process.