Senior Financial Government Reimbursement Analyst

Emory Healthcare•Tucker, GA

1d•Remote

About The Position

Serves as a senior technical subject matter expert responsible for the independent preparation, coordination, and optimization of Medicare, Medicaid, Tricare, and other governmental cost reports and regulatory filings across the health system. Owns end-to-end cost report production for assigned entities - including data collection, workpaper development, settlement modeling, and filing coordination - while interpreting and applying CMS and State Medicaid regulations to ensure compliant, optimized reimbursement outcomes. Serves as a key liaison with Decision Support, General Accounting, Patient Financial Services, Case Management, and GME to validate data integrity and ensure accurate reporting. Monitors MAC correspondence, settlement notices, and regulatory communications. Supports reimbursement forecasting and reserve development through settlement modeling, interim rate analysis, and pass-through payment validation.

Requirements

Bachelor's degree in Accounting, Finance, or Business.
5 years minimum experience in accounting/finance with 3 years in reimbursement or cost reporting
Working knowledge of hospital patient accounting, general ledger, and decision support systems (Epic, Strata, or equivalent)
Knowledge of pass-through payment structures, lump sum adjustments, and interim rate reconciliation
Ability to communicate complex reimbursement concepts clearly to finance, clinical, and operational stakeholders
Experience interfacing with MACs, CMS, and state agencies during audits, desk reviews, and appeals
Comfortable managing multiple filing deadlines and regulatory timelines simultaneously

Nice To Haves

Master's Degree in finance or accounting
7 years minimum experience with at least 5 years in reimbursement or cost reporting
Organ Acquisition, 340B, and IRIS experience preferred

Responsibilities

Prepare Medicare, Medicaid, and Tricare cost reports for assigned entities, managing the full cycle from data collection and workpaper development through filing coordination.
Interpret and apply CMS and State Medicaid regulations to ensure compliant reporting and identify reimbursement optimization opportunities.
Support Wage Index and Occupational Mix survey preparation and filing.
Lead preparation and analysis of complex settlement components including Medicare bad debt, DSH, S-10 uncompensated care, IME/GME, organ acquisition, ESRD, transplant, and other pass-through or supplemental payment programs.
Validate pass-through payments and lump sum adjustments; reconcile interim rates against settled amounts.
Coordinate supporting documentation and audit trails required for desk reviews, audits, and appeals.
Monitor MAC correspondence, settlement notices, and regulatory communications; coordinate responses and required documentation.
Support audit strategy development and defend filed positions through the appeals process.
Prepare monthly third-party settlement model supporting month-end close and reserve reporting.
Support reimbursement forecasting and reserve development through settlement outcome modeling and interim rate change analysis.
Partner with Decision Support, General Accounting, PFS, Case Management, and GME to validate data integrity and ensure accurate reimbursement reporting.
Identify and resolve data discrepancies impacting cost report accuracy or settlement outcomes.
Additional Duties as Assigned.