Senior Reimbursement Analyst - Net Revenue

WVU Medicine

106d

About The Position

This position is responsible for the reimbursement of all payers; tasks will include filing compliant cost reports, primary contact on assigned audits, and participating in the month end close process. Advance Excel skills/knowledge is needed in this role. This individual must be able to handle multiple tasks and see each to completion with minimal supervision. Also, responsible for some training of new analyst on department procedures and systems. Effective communication is important, as this role will interact with various departments.

Requirements

• Bachelor’s Degree in business administration, accounting, or finance.
• Five (5) years’ of experience in finance or accounting.

Nice To Haves

• Advanced degree or Certification in accounting, finance, or healthcare administration.
• Experience working in a health care or health system environment.
• Experience working with CMS and/or Medicare auditors.
• Experience with EPIC, Workday, Lawson, Strata Jazz and TOYON Absolute software.
• Advanced computer and spreadsheet skills, primarily in Excel.

Responsibilities

• Prepare the annual cost reports for Medicare, Medicaid and TRICARE in accordance with government regulations.
• Analyze reports for increased reimbursement with an understanding of CCR and their impact on reimbursement.
• Primary contact on assigned hospital audits, work diligently to minimize reimbursement impact to hospital.
• Assessing the monthly cost estimate for necessary changes or material variances relating to hospital operations throughout the year.
• Prepare annual Reimbursement Budget models on assigned hospitals with accuracy using final regulations, and Strata revenue and statistical reports.
• Coordinates the completion and preparation of the annual Uniform Report (UFR) for the WV Healthcare Authority.
• Understanding of Method II reimbursement and the impact on payments and deductions.
• Understanding of IME/GME, DSH, RHC, bad debts and other medical education programs.
• Look for opportunities to automate and improve current processes with a goal of increasing accuracy and efficiency.
• Analyze monthly contractual reserve estimates and communicate to management material changes to A/R.
• Prepare journal entries.
• Assist with the training of new analysts on department procedures and systems.
• Prepare Medicaid DSH survey and template for DSH Audits.
• Responsible for the review of DSH audit adjustments for accuracy.
• Primary contact on Wage Index and Occupational Mix audits.
• Review proposed adjustments from auditors and PUF files for accuracy.
• Update third party reserves and review monthly supplemental and pass through schedules for accuracy.
• Prepare necessary journal entries.
• Verify and analyze interim rate calculations and final settlements by third party payer for accuracy.
• Responsible for distributing updated rates to internal departments.
• Promotes and contributes positively to the department by assisting with team members’ questions, contributing ideas and problem solving.
• Takes a leadership role in performance improvement through planning and implementing change.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees