Lead Reimbursement Analyst - Finance
About The Position
The Lead Reimbursement Analyst will perform calculations and analysis of accounts receivable, valuation, and third-party reimbursement reporting. This role involves coordinating audits and monitoring regulation changes. The analyst will prepare and file Medicare and Medicaid cost reports and Blue Cross cost studies to maximize reimbursement for UAB St. Vincent’s Health System. Responsibilities include acting as a liaison between the hospital and local intermediary, preparing quarterly mini cost reports, and preparing monthly journal entries for reimbursement adjustments. The position also involves analyzing payer reimbursement methodologies, preparing reimbursement calculations and projections, identifying reimbursement variances, and supporting managed care contract analysis.
Requirements
- Bachelor’s degree in Finance, Accounting, Healthcare Administration, Business, or related field required.
- 2 years of healthcare reimbursement, revenue cycle, or financial analysis experience required
Nice To Haves
- 4 years preferred.
Responsibilities
- Perform the calculations and analysis of accounts receivable and valuation and third party reimbursement reporting, coordination of audits and monitoring of regulation changes.
- Prepare and file the Medicare and Medicaid cost reports and Blue Cross cost studies to ensure the maximization of reimbursement received by UAB St. Vincent’s Health System.
- Act as liaison between Hospital and local intermediary.
- Prepare quarterly mini cost reports.
- Prepare monthly journal entries for reimbursement adjustments.
- Assist in the preparation, review, and filing of Medicare and Medicaid cost reports.
- Review supporting schedules and coordinate with external advisor and fiscal intermediary for preparation of annual reports.
- Ensure compliance with CMS regulations, state Medicaid rules, and payer-specific requirements.
- Prepare applications and accounting for any state supplemental payment programs.
- Prepare reports and prepare month end journal entries in general ledger.
- Maintain documentation supporting reimbursement calculations and regulatory filings.
- Prepare Retro models.
- Analyze payer reimbursement methodologies including Medicare, Medicaid, managed care, and commercial contracts and calculates financial impact of changes in reimbursement.
- Prepare reimbursement calculations and projections for inpatient, outpatient, physician, and ancillary services.
- Identify reimbursement variances, underpayments, and revenue opportunities; recommend corrective actions.
- Support managed care contract analysis, modeling, and negotiation preparation.
- Assist with modeling proposed contract changes and renewals.
- Reconcile reimbursement payments to expected rates.
- Partner with Revenue Cycle, Patient Financial Services, and Clinical departments to resolve reimbursement issues.
- Serve as a reimbursement subject-matter resource for internal stakeholders.
- Participate in audits, appeals, and payer inquiries as needed.
- Assist the manager and director with budgeting and modeling net patient service revenue.
- Performs other duties as assigned.
Benefits
- generous paid time off
- paid parental leave
- Associate Assistance Program
- Tuition Reimbursement Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
