Senior Reimbursement Analyst
About The Position
The Senior Reimbursement Analyst prepares, reviews, and files Medicare and Medicaid cost reports for all OhioHealth entities and helps ensure appropriate governmental reimbursement. The role proactively calculates and models the effects of regulatory changes, analyzes variances in third-party liability accounts, and prepares supporting work papers and documentation for third-party inquiries. The position provides supervisory oversight of the Reimbursement Analyst’s daily work, including coordinating information flow, teaching reimbursement fundamentals, reviewing work, and setting priorities. It also supports the Sr. Reimbursement Consultant, Reimbursement Advisor, Manager of Reimbursement, and other leaders on projects and processes. Over time, the analyst develops subject-matter expertise in areas including S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical Education, and Ohio governmental programs such as HCAP, UPL, and Franchise Fee. The role requires ongoing learning of federal and state Medicare and Medicaid reimbursement regulations, strong interpersonal communication, and effective prioritization, planning, and communication in a heavily matrixed environment. The position has a matrix reporting structure and reports to the Manager of Reimbursement, Sr. Reimbursement Consultant, Reimbursement Advisor, and Director of Revenue Reimbursement.
Requirements
- Bachelor’s degree in Finance.
- Two to four years of experience with Medicare/Medicaid cost reporting as a Reimbursement Analyst or in a similar position.
- Knowledge of CMS cost reporting, disproportionate share (DSH), uncompensated care, bad debt reporting, IME/GME, Medicare Wage Index, S-10 reporting, Tricare and 855s, Ohio Medicaid, HCAP, UPL, and Franchise Fee programs.
- Knowledge of Acute Care Hospitals, Critical Access Hospitals, Sole Community Hospitals, and Rural Health Clinics.
- Knowledge of reimbursement in specialty areas such as psychiatry, inpatient rehabilitation units, Home Health, and Hospice.
- Strong interpersonal, communication, prioritization, and planning skills for work in a heavily matrixed environment.
- Ongoing learning of federal and state Medicare and Medicaid cost-reporting and reimbursement regulatory requirements.
Nice To Haves
- CPA, MHA, or MBA.
Responsibilities
- Prepare, review, and file Medicare and Medicaid cost reports for all OhioHealth entities.
- Help ensure appropriate governmental Medicare and Medicaid reimbursement for OhioHealth entities.
- Calculate and model the effects of new regulatory changes and analyze variances in third-party liability accounts.
- Prepare supporting work papers and documentation for third-party inquiries.
- Oversee the Reimbursement Analyst’s daily work schedule, information flow, work review, and daily priorities; teach reimbursement fundamentals and principles.
- Support the Sr. Reimbursement Consultant, Reimbursement Advisor, Manager of Reimbursement, and other leaders on projects and processes.
- Develop subject-matter expertise in reimbursement areas including S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical Education, and Ohio governmental programs.
- Provide updates to the Director of Revenue and Reimbursement and Manager.
- Work with CGS auditors and the legal vendor on Medicare appeals.
- Work with OHA and CBSA facilities on wage index opportunities.
- Complete special projects and analyses as assigned by the Director of Revenue and Reimbursement and Manager.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
