Senior Reimbursement Analyst - Revenue Management

Overview

This role provides analytical and reimbursement support for reimbursement functions, including Medicare, Medicaid, and other third-party cost report-related audits, appeals, disproportionate share hospital (DSH), and drug discount program (340B) CPT/HCPCS code changes for assigned entities (4–6). The analyst completes monthly and year-end entries for third-party reserves and summarizes data for market and local finance leadership.

Responsibilities

• Prepare workpapers; review and submit annual Medicare and Medicaid cost reports and other regulatory filings required on behalf of the System.
• Coordinate Medicare and Medicaid cost report reviews and audits, including:
  • overall cost report
  • wage index
  • bad debt
  • S-10
  • Medicaid log
  • Medicaid eligible days
• Prepare monthly settlement reserve entries.
• Research reimbursement and regulatory issues and provide analyses to the System Director or other stakeholders.
• Review net revenue analytics and identify areas requiring additional analysis.
• Assist with the annual budgeting process for net revenue.
• Produce reports, analyze and integrate data, and complete other projects accurately and efficiently.
• Prepare reimbursement-related reports or analyses as needed to support reimbursement leadership.

Requirements

• Bachelor’s degree in Accounting or Finance required.
• Minimum 3 years of experience in consulting or multi-hospital acute-care health system work related to Medicare and Medicaid reimbursement and cost report preparation.
• Ability to research reimbursement issues and provide practical and concise interpretations.
• Strong organizational skills; critical thinking to query appropriate data for projects.
• Excellent analytical and computer skills.
• Ability to effectively communicate and interact with regional and corporate office associates.
• Excellent oral and written communication skills and strong interpersonal skills.
• Ability to work independently and proactively with limited supervision.

Preferred Qualifications

• Master’s degree in Accounting or Finance.
• Experience with Ohio, Kentucky, Virginia, and/or South Carolina Medicaid reimbursement; Medicare medical education reimbursement; Medicare wage index and/or Medicare critical access hospital reimbursement.

Compensation & Benefits

• Competitive pay, incentives, referral bonuses, and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources, and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development, and continuing education support
• Benefits may vary based on the market and employment status

Location & Schedule

• Scheduled Weekly Hours: 40
• Work Shift: Days (United States of America)

Equal Opportunity

The employer is an equal opportunity employer and follows federal and state laws. Applicants will receive consideration without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability.

Department

SS Revenue Management - Reimbursement