Reimbursement Analyst

Advocate Health • Milwaukee, WI

2d • $33 - $50 • Remote

About The Position

The Reimbursement Analyst will assist with plans and prepares revenue analysis for system-wide programs, projects, and services, and monitors revenue budgets and benchmarking activities. This role acts as support for all system intermediary data requests, audits, and exit conferences. The analyst will assist in the preparation and provide necessary information for system-wide external financial audits, and Medicare and Medicaid interim and year-end cost reports. They will also assist with the coordination of the year-end system financial audit with external auditors and reimbursement staff, and develop and maintain appropriate relationships with the Fiscal Intermediary and external auditors. The position involves preparing analysis and assisting in making recommendations to ensure that all regulatory reviews are completed accurately and on time. The analyst will participate in the development and preparation of the system-wide budgeting for Gross and Net Patient Revenue to ensure accuracy, timeliness, and compliance with accounting standards. They will analyze and review the monthly accounts receivable valuation and provide recommendations to ensure optimal reimbursement, understanding and overseeing the tools used for calculation. The role involves developing and providing coordination for the system-wide monthly closing process with respect to Medicare/Medicaid liabilities and the allowances on patient receivables. The analyst will monitor processes to ensure accurate payment for Medicare/Medicaid and monitor interim payments to determine accuracy, appropriateness, and potential liability, requesting adjustments from United Government Services (UGS) and updating internal systems. Finally, the analyst will develop and apply an understanding of Medicare and Medicaid regulations pertaining to current and proposed reimbursement and work directly with Government Affairs and external consultants to provide needed expertise. This role will coordinate with the Financial Planning department(s) the preparation of System budgets as they pertain to third-party reimbursement and provide support to Financial Planning in the development of retrospective financial review and pro forma development.

Requirements

• Bachelor's Degree in Finance or related field.
• Typically requires 3 years of experience in reimbursement that includes experiences in preparation of Medicare/Medicaid cost reports, regulations and the analysis, modeling and reporting of third party payers.
• Demonstrated expertise with Medicare and Medicaid regulations in a health care or federal intermediary setting.
• Knowledge and understanding of third party regulations and the interrelationship of financial statements to not only comply with regulations but to maximize and develop strategies to increase the organization's reimbursement rate with ongoing changes.
• Demonstrates strong initiative and produces high quality analytical results.
• Able to perform tasks independently.
• Strong accounting background with experience in preparing and/or reviewing health care financial statements which are required to perform accurate account analysis.
• Strong proficiency in the use of the Microsoft Office (Excel, PowerPoint, Word, Access), software systems, data management tools or similar products.
• Proficiency in data mining and analysis.
• Demonstrated ability to work and function in a complex environment.
• Excellent written and verbal communication skills and the ability to communicate revenue cycle issues to all levels of the organization.
• Demonstrated ability to take initiative, produce high quality results, and perform assigned activities in an independent manner.
• Self-motivated and capable of carrying a project through to successful completion.

Nice To Haves

• Advanced Excel skills
• Accounting skills
• Healthcare experience
• PowerBI experience
• Analytic tools in Epic; Slicer/Dicer and/or Reporting Workbench
• Accounts receivable experience
• Ledger entry experience

Responsibilities

• Assist with plans and prepares revenue analysis for system wide programs, projects and services, and monitors revenue budgets and benchmarking activities.
• Acts as support for all system intermediary data requests, audits and exit conferences.
• Assists in preparation and provides necessary information required for the completion of system wide external financial audits, and Medicare and Medicaid interim and year-end cost reports.
• Assists with coordination of the year-end system financial audit with external auditors and reimbursement staff.
• Develops and maintains appropriate relationships with the Fiscal Intermediary and external auditors.
• Prepares analysis and assists in making recommendations to ensure that that all regulatory reviews are completed accurately and on time.
• Participates in the development and preparation of the system wide budgeting for Gross and Net Patient Revenue to ensure accuracy, timeliness, and compliance with accounting standards.
• Analyzes and reviews the monthly accounts receivable valuation and provides recommendations to ensure optimal reimbursement.
• Understands and oversees the tools used for calculation.
• Develops and provides coordination for the system wide monthly closing process with respect to Medicare/Medicaid liabilities and the allowances on patient receivables.
• Monitors processes to ensure accurate payment for Medicare/Medicaid and monitors interim payments to determine accuracy, appropriateness and potential liability.
• Requests adjustments from United Government Services (UGS) and updates internal systems.
• Develops and applies an understanding of Medicare and Medicaid regulations pertaining to current and proposed reimbursement.
• Works directly with Government Affairs and external consultants to provide needed expertise.
• Coordinates, with the Financial Planning department(s), the preparation of System budgets as they pertain to third party reimbursement.
• Provides support to Financial Planning in the development of retrospective financial review and pro forma development.

Benefits

• Comprehensive suite of Total Rewards: benefits and well-being programs
• Competitive compensation
• Generous retirement offerings
• Programs that invest in your career development
• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance
• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level