Lead Reimbursement Analyst - Finance

UAB St. Vincent's•Birmingham, AL

2d•Hybrid

About The Position

The Lead Reimbursement Analyst will perform calculations and analysis of accounts receivable and valuation and third-party reimbursement reporting, coordination of audits, and monitoring of regulation changes. This role involves preparing and filing Medicare and Medicaid cost reports and Blue Cross cost studies to maximize reimbursement for UAB St. Vincent’s Health System. The analyst will act as a liaison between the Hospital and local intermediary, prepare quarterly mini cost reports, and prepare monthly journal entries for reimbursement adjustments. Responsibilities also include assisting with the preparation, review, and filing of Medicare and Medicaid cost reports, reviewing supporting schedules, and coordinating with external advisors and fiscal intermediaries for annual reports. Ensuring compliance with CMS regulations, state Medicaid rules, and payer-specific requirements is crucial. The role involves preparing applications and accounting for state supplemental payment programs, preparing reports, and making month-end journal entries to the general ledger. Maintaining documentation for reimbursement calculations and regulatory filings, preparing Retro models, and analyzing payer reimbursement methodologies are key duties. The analyst will calculate the financial impact of changes in reimbursement, prepare reimbursement calculations and projections for various services, and identify reimbursement variances, underpayments, and revenue opportunities, recommending corrective actions. Support for managed care contract analysis, modeling, and negotiation preparation, including modeling proposed contract changes and renewals, is expected. Reconciling reimbursement payments to expected rates and partnering with Revenue Cycle, Patient Financial Services, and Clinical departments to resolve reimbursement issues are also part of the role. The Lead Reimbursement Analyst will serve as a reimbursement subject-matter resource for internal stakeholders and participate in audits, appeals, and payer inquiries. Additionally, the role involves assisting the manager and director with budgeting and modeling net patient service revenue. Other duties as assigned will be performed.

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.
With minimal supervision prepares and files 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; acts as liaison between Hospital and local intermediary; prepares quarterly mini cost reports; and prepares 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.