Senior Reimbursement Analyst

Prime HealthcareLewiston, ME
1dHybrid

About The Position

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.

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.
  • Complile, 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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