Sr. Reimbursement Analyst

Overview

The Senior Reimbursement Analyst is responsible for the integrity of net revenue and supports regulatory reimbursement services. This role includes cost report preparation, cost report appeals, and audit preparation, while maintaining current knowledge of Medicare, Medicaid, and other State and Federal regulations. The position interacts with customers and helps ensure value delivery and customer satisfaction. The role also assists with coordination of net revenue functions tied to strategic financial planning and supports improvement of internal business processes.

Responsibilities

• Prepare interim estimates and annual cost reports for Medicare, Medicaid, and other State or Federal agencies for assigned facilities; proficient use of Cost Report software.
• Prepare monthly reserve models and provide analysis of net revenue variances for assigned entities, including bad debt and other revenue adjustments in accordance with organizational policies and procedures.
• Prepare Third Party Settlement estimates and maintain reconciliation of related balance sheet accounts.
• Analyze and report changes in monthly reserves; investigate and recommend updates to assumptions and/or methodology.
• Provide projections and analytical support during fiscal year budgeted net revenue preparation.
• Maintain standardized reimbursement department policies and procedures; review operational reports, identify opportunities/problems, and recommend process and methodology improvements.
• Train reimbursement analysts on new responsibilities.
• Coordinate Medicare, Medicaid, and other State or Federal agency cost report audits by providing supporting documentation, reviewing audit adjustments, and responding to audit findings timely and efficiently.
• Maintain working knowledge of NC Medicaid Programs, including HASP, Direct and Enhanced Payments; record appropriate entries for applicable facilities for payments received; complete schedules as required by the state of NC.
• Maintain working knowledge of net revenue software and work with IT/vendors to ensure information is updated timely for accurate net revenue recording across organizational entities; extract and process data to support net revenue review.
• Maintain working knowledge of Indirect and Direct Medical Education and provide request reimbursement analysis on Program Changes.
• Support financial statement audits related to Net Revenue; provide support for balance sheet reserves and estimates; perform analysis for variance inquiries.
• Complete special projects as required.

Requirements

• Bachelor’s Degree or higher required.
• Minimum five years of experience with Medicare and Medicaid in a Reimbursement Department.
• Working knowledge of reimbursement regulations and a complex healthcare environment is required.

Compensation & Benefits

• Pay range: $68,806.40 - $100,294.48/year
• Great benefits

Location

• Remote role (based out of Greenville, NC)
• Monday–Friday day shift: 8:00 a.m. - 5:00 p.m.
• Occasional weekends due to regulatory requirements

Other Information

• Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.
• Equal opportunity employer; employment decisions are based on business needs, job requirements, and applicant qualifications without regard to protected status under applicable law.