Senior Financial Reimbursement Analyst

Emory•Atlanta, GA

14d

About The Position

The Senior Financial Reimbursement Analyst will work independently with managerial oversight to gather documents and coordinate the filing of Medicare/Medicaid/Tricare cost reports. They will also assist in the filing of the Georgia Department of Community Health (DCH) Indigent Care Trust Fund (ICTF) Survey. The Senior Financial Analyst will review and provide support for any information or data required for the settlement of Medicare bad debt, disproportionate share, medical education and other components. They will monitor DCH and CMS reimbursement correspondence to communicate information and coordinate resolution of requested information, as needed. They will support the Reimbursement Manager with the review and analysis of both Centers Medicare and Medicaid Services (CMS) regulations and Georgia Department of Community Health (DCH) policies, ensuring accuracy of reimbursement rates and modeling of financial impact.

Requirements

Bachelor's Degree BS/BA Degree in Accounting or Business Required
Minimum 5 years in accounting/finance
Minimum 3 years in an analyst role, preferably experience with a Medicare Administrative Contractor
Experience in the preparation and analysis of Medicare and Medicaid cost reports and DCH regulatory surveys is highly desirable
Analytical skills, Computer skills with intermediate excel for data extraction, presentation skills, accounting skills, government programs reimbursement knowledge, good communication skills, ability to interact professionally with multiple departments including financial accounting, patient financial services, and managed care.
Able to handle multiple tasks.

Responsibilities

Be responsible for the preparation of the Medicare/Medicaid/Tricare cost reports, audits and appeals.
Gather data and complete the filing of all cost reports for the hospitals.
Work with decision support team on the development and review of operational statistics.
Help to develop a workplan for the completion of the annual cost reports.
Work on the preparation and reporting of all Medicare bad debt list and related information, transplant, DSH, medical education, ESRD, paramedical and other critical components filed with the Medicare cost report as well as assist in the compiling and filing of the ICTF survey
Ensures all third-party pass thru payments and lump sum adjustments are received as communicated by the Medicare Administrative Contractor (MAC) and are accurate versus expected reimbursement
Assists with the preparation of the Wage Index and Occupational Mix Survey filings and reviews
Also, DRG and APC reporting/benchmarking and other reimbursement pattern analysis.
Work with the reimbursement team to develop and report DRG and APC payment updates.
Work on the annual analysis of the DRG and APC impact analysis.
Work with the Reimbursement Manager to issue a payment update bulletins on Federal and State regulations.
Provides documentation for use in calculating monthly Medicare/Medicaid/Tricare reserve requirements