Senior Government Reimbursement Analyst - Finance Operations - Full Time 8 Hour Days (Exempt) (Non-Union)
About The Position
This Senior Analyst of Government Reimbursement at Keck Medicine of USC position will support governmental reporting and reimbursement, focusing on tasks such as preparing and ensuring compliance with the Medicare Cost Report (MCR) and related Medicaid Cost Reports. Additionally, the role involves analyzing payment methods, staying current with regulatory changes, and supporting cost report preparation and audits. The analyst works collaboratively with finance, revenue cycle, compliance, and clinical teams to maintain proper reimbursement under government program rules. This analyst will coordinate with specialty operational units to keep up with evolving CMS rules and regulations. Some specialty areas include subacute units, a certified transplant center, a PPS-exempt dedicated cancer hospital delivering BMT and CAR-T therapies. An ideal candidate has experience in PPS and non-PPS reimbursement and a working knowledge of regulatory and compliance requirements therein.
Requirements
- Bachelor's Degree in Finance, Health Administration, Business, Accounting or related field.
- 3 years hospital reimbursement, with a strong focus on government payers including Medicare and Medicaid.
- Experience with CMS and state Medicaid hospital payment systems and cost reporting requirements.
- Experience with Medicare and Medicaid reimbursement guidelines including audits and appeals processes.
- Strong analytical, organizational, and communication skills.
- Sound business judgment and creative problem-solving attributes.
- Experience in GAAP and healthcare financial accounting/reporting consolidation processes.
- Demonstrate skills in project planning, reviewing, and ensuring work is organized and documented.
- Working knowledge of Hospital Revenue Cycle (Patient accounting, collections, denials, etc.) and related reporting.
- Proficiency with Microsoft Office (i.e., Excel, Word, PowerPoint).
- Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only).
Nice To Haves
- Master's degree in Accounting, Finance or Health Administration.
Responsibilities
- Support the preparation and submission of all Medicare, Medi-Cal and Tri-Care cost report filings and amendments on behalf of Keck Medicine of USC, home office and its hospitals. Review statistical, financial, and departmental data for accuracy and compliance with CMS and state regulations escalating discrepancies to the Manager as needed.
- Maintain detailed records of audits, data requests, auditor sampling, responses, and appeals. Review audit adjustments for accuracy and update internal reporting processes. Identify potential items for formal Medicare appeal and provide recommendations to the Manager for operational improvements based on audit findings,
- Prepare Medicare Cost Report (MCR)-related journal entries and balance sheet reconciliations. Support monthly settlement account estimates, related analysis, and third-party audits. Generate ad hoc reports to assist with institutional monthly financials. Respond to inquiries and other requests for information, escalating complex issues to the Manager as needed.
- Monitor and interpret CMS, Medicare, and Medicaid reimbursement, including proposed and final IPPS and OPPS rules, CMS bulletins, and related litigation. Summarize key updated and provide concise briefings to the Manager and reimbursement leadership.
- Partner with Finance, Revenue Cyle, and third-party vendors to collect and validate data for reimbursement-related activities, including Medicare bad debt, and DSH reporting. Provide analytical support and insights to Manager on reimbursement impacts and compliance.
- Perform other duties as assigned by the Manager to support the reimbursement function and broader departmental goals.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Educational Services
Number of Employees
5,001-10,000 employees
