Reimbursement Analyst III
About The Position
Cost Reporting- Prepare the Medicare/Medicaid Cost reports by developing supporting schedules. Develop supporting work papers in accordance with government cost reporting principles for management's review. Enter data into Medicare/Medicaid Cost Report Software. Progressive knowledge of Center for Medicare & Medicaid Services (CMS) cost reporting, DSH exam log files, IME/GME, Medicare Wage Index, Medicaid cost reporting and HCAP/Uncompensated Care. Responsible for 340B Trial Balance, registration, and recertification. Cost Accounting- Responsible for classifying new cost centers by analyzing whether the labor matches the revenue generated and if not revenue whether or not the expense should directly reclassified or indirectly allocated as overhead and which overhead category is appropriate. Develop and organize detailed work papers to support quarterly costing data. Recommend approaches for improvement activities, recommend and perform new processes, collect and measure data, develop processes based on performance and communicate results. Data Analysis- Strong working knowledge of the state & federal cost reporting requirements in order to extract compliant data using our existing business intelligence software. Compare data to prior year to identity large variances that need further analysis, explanation, and documentation. Compliance- Stay current with the latest CMS and State Medicaid regulations related to cost reporting, reimbursement, and payment methodologies. Understand and communicate the implication that changes to regulations will have on the institution and proactively work to support changes to comply with new regulations. Ability to model the regulatory changes to engage and educate leadership. Collaboration- Establish working relationships with cross-functional teams, such as IS, reimbursement/billing and hospital/clinical services to obtain data for cost reporting needs. Assist external parties (auditors, regulatory agencies) during audits including collaborating with other departments across the hospital to manage these requests. Provide reimbursement and regulatory updates to varying levels of leadership. Assist department leadership with training needs, review of work, and setting daily priorities.
Requirements
- Bachelor's degree in a related field
- 7+ years of work experience in a related job discipline
- 4+ years of Medicare cost reporting experience
- MS Excel, Access, and Business Intelligence experience
- Familiar with CMS Medicare/Medicate cost reports including various cost reporting worksheets included but not limited to Worksheet C, D, G, H, I and B-1 statistics.
Nice To Haves
- Master's degree in a related field
- CPA
Responsibilities
- Prepare the Medicare/Medicaid Cost reports by developing supporting schedules
- Develop supporting work papers in accordance with government cost reporting principles for management's review
- Enter data into Medicare/Medicaid Cost Report Software
- Responsible for 340B Trial Balance, registration, and recertification
- Responsible for classifying new cost centers by analyzing whether the labor matches the revenue generated and if not revenue whether or not the expense should directly reclassified or indirectly allocated as overhead and which overhead category is appropriate
- Develop and organize detailed work papers to support quarterly costing data
- Recommend approaches for improvement activities, recommend and perform new processes, collect and measure data, develop processes based on performance and communicate results
- Strong working knowledge of the state & federal cost reporting requirements in order to extract compliant data using our existing business intelligence software
- Compare data to prior year to identity large variances that need further analysis, explanation, and documentation
- Stay current with the latest CMS and State Medicaid regulations related to cost reporting, reimbursement, and payment methodologies
- Understand and communicate the implication that changes to regulations will have on the institution and proactively work to support changes to comply with new regulations
- Ability to model the regulatory changes to engage and educate leadership
- Establish working relationships with cross-functional teams, such as IS, reimbursement/billing and hospital/clinical services to obtain data for cost reporting needs
- Assist external parties (auditors, regulatory agencies) during audits including collaborating with other departments across the hospital to manage these requests
- Provide reimbursement and regulatory updates to varying levels of leadership
- Assist department leadership with training needs, review of work, and setting daily priorities
Benefits
- Medical coverage starting day one of employment.
- Competitive retirement plans
- Tuition reimbursement for continuing education
- Expansive employee discount programs through our many community partners
- Shift Differential, Weekend Differential, and Weekend Option Pay Programs for qualified positions
- Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQA Resource Group, Juntos - Hispanic/Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group
- Physical and mental health wellness programs
- Relocation assistance available for qualified positions
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Hospitals
Number of Employees
5,001-10,000 employees
