Senior Reimbursement Analyst
About The Position
Central Maine Healthcare is an integrated healthcare delivery system serving 400,000 people living in central, western and Midcoastal Maine. CMH's hospital facilities include Central Maine Medical Center in Lewiston, Bridgton Hospital and Rumford Hospital. CMH also supports Central Maine Medical Group, a primary and specialty care practice organization. Other system services include the Central Maine Heart and Vascular Institute, a regional trauma program, LifeFlight of Maine's southern Maine base, the Central Maine Comprehensive Cancer Center and other high-quality clinical services. Central Maine Healthcare is seeking a Full Time, Senior Reimbursement Analyst to join our team! Position Summary: Completes specific assigned responsibilities as it relates to cost reporting, month-end contractual and third party receivables. Responsible for supporting and assuring accurate preparation of the annual Medicare & Medicaid Cost reports for one acute, two critical access hospitals and a home office. Assists in the completion of month-end accounts receivable analysis, calculating necessary reserves on patient AR by payer and completing interim cost report estimates and yearly contractual allowance budgets. Responsible for the reconciliation of third-party payer logs, physician time studies and graduate medical education data. Hybrid position/partially remote.
Requirements
- Bachelor’s Degree in accounting, finance or related field
- Five years to eight years reimbursement experience
Nice To Haves
- Prior healthcare or cost report experience preferred
Responsibilities
- Prepare and file Medicare and Medicaid Cost Reports for Central Maine Healthcare hospitals as well as home office.
- Maintain various schedules utilized in the preparation of annual cost reports including physician time studies, graduate medical education data and B-1 statistics.
- Work with Medicare and Medicaid auditors and other third parties to ensure that settlements are complete and accurate and that auditor’s requests are responded to in a timely and appropriate manner.
- Prepare monthly adjusting entries for the contractual allowances by completing AR models and investigate and explain variances to budgeted deductions from revenue.
- Complete monthly interim cost report models for critical access hospitals and prepare entries to record the net change in third party liabilities.
- Assists in the preparation of the budget for deductions from net revenue for three hospitals.
- Identify, communicate, and assist with resolution of systemic issues causing incorrect reimbursement by maintaining and utilizing contract management software and other net revenue analysis by payer.
- Responsible for the configuration and maintenance of multiple databases using Microsoft Access.
- Compline, analyze, and reconcile various third party payment logs.
- Complete Ad Hoc analysis assigned by the Reimbursement Manager and Director of Reimbursement.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
