Government Reimbursement Analyst II

University of Missouri Health Care • Columbia, MO

3d

About The Position

This role ensures accurate Medicare and Medicaid reimbursement processes for MU Health Care and its affiliates, identifying and addressing compliance issues and overseeing the appeal process. You will review and implement new regulations, coordinate audits for cost reports, and liaise with auditors to resolve discrepancies. Additionally, you will manage the development of contracting modules and mentor the Government Reimbursement Analysts I. Key responsibilities also include coordinating the annual Medicare cost report and identifying opportunities for process improvements through data analysis. Building relationships with governmental stakeholders is essential to ensure proper reimbursement and compliance.

Requirements

• Bachelor's degree in accounting, business administration or related field, or an equivalent combination of education and experience from which comparable knowledge and abilities can be acquired.
• Three (3) years of experience in a healthcare reimbursement setting with experience in Medicare and Medicaid cost report preparation and submission.

Nice To Haves

• Experience in preparing and understanding the following sections of the Medicare and Medicaid cost reports:
• DSH (Disproportionate Share Hospital) calculations
• Medicare Bad Debt submissions and audits
• Wage Index
• S-10 reporting for uncompensated care cost and audits
• Preparing the Intern and Resident Information System (IRIS) disk. Knowledge with New Innovations is a plus
• Additional license/certification requirements as determined by the hiring department.

Responsibilities

• Assist in the identification of Medicare and Medicaid reimbursement and compliance issues that should be reported and/or appealed, recommend appropriate outside resources for pursuing appeals, monitor the process to ensure that appeals or exception requests are filed promptly, and follow up to ensure timely resolution.
• Review, interpret, and implement new or revised regulations that affect reimbursement planning for MU Health Care and its affiliates.
• Coordinate the Medicare, Medicaid, S-10, and Ground Emergency Medical Transport (GEMT) audits of filed cost reports and Medicaid Disproportionate Share Hospital (DSH) program. Liaison with auditors to provide accurate explanatory information, retrieve and verify data as requested, review audit adjustments, and coordinate necessary responses. Data may include, but is not limited to, financial and patient accounting documents, payroll information, and asset and transaction records.
• Oversee the maintenance and development of contracting modules. Mentor and train Reimbursement Analysts on the expected payment modeling process in the financial decision support system for Medicare and Tricare by analyzing CMS regulations and Tricare payment methodologies, respectively. Project lead on any decision support contracting upgrades.
• Participate in the performance of special data accumulations, studies, and projects requested by internal management, CMS, or other external sources, as necessary.
• Coordinate the annual Medicare cost report, wage index review, and occupational mix survey. Liaison between the hospital and outside vendors.
• Analyze data trends, identifying opportunities for process improvement, standardization, and automation.
• Collaborate with internal and external partners to gather information and resolve issues or discrepancies.
• Develop and maintain relationships with key governmental stakeholders (Federal and State) to facilitate proper governmental reimbursement.
• May complete unit/department-specific duties as outlined in department documents.

Benefits

• Health, vision and dental insurance coverage starting day one
• Generous paid leave and paid time off, including nine holidays
• Multiple retirement options, including 100% matching up to 8% and full vesting in three years
• Tuition assistance for employees (75%) and immediate family members (50%)
• Discounts on cell phone plans, rental cars, gyms, hotels and more

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees