Senior Reimbursement Analyst

JOB SUMMARY

Assists Manager of Revenue Integrity and Reimbursement with month-end close reimbursement analysis, various cost report preparations, varied financial analyses, financial forecasts, annual budget assistance, annual independent audit assistance, managed care contract analysis. Strives for superior performance by consistently providing a product or service to leadership and staff that is recognized as ultimately contributing to the patient and family experience.  Recognizes and demonstrates understanding of patient and family centered care. 

PRIMARY JOB RESPONSIBILITIES

1. Strong familiarity with Medicare and Medicaid cost reports to prepare work papers for third-party costs reports and utilizes outside consultants as appropriate and assist in various phases of third-party cost report audit.
2. Assist in various phases of annual independent audit by Certified Public accounting firm as well as mid-year review of third-party contractual allowances.
3. Interaction with the consulting firm that assists with cost reports and reimbursement issues/studies.
4. Assist with preparation of monthly financial reimbursement model for monthly accounting closes. Interacts with Manager of Revenue Integrity and Finance Director.
5. Assists in preparation and analysis of internal periodic departmental/product line analysis.
6. Assists with periodic cost accounting analysis including development of pricing for new services not covered by payers, analysis of new services and gain/loss on implementation of new service.
7. Assist in contract analysis and negotiations by providing reimbursement analysis on a variety of fee schedules, CPT/HCPCs codes.
8. Assist with financial forecasts and assist with annual revenue budget.
9. Assist with annual budget for third-party contractual allowances.

1. Demonstrates knowledge of and supports hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality statements, corporate compliance plan, customer service standards, and the code of ethical behavior.
2. Other duties as assigned

JOB SPECIFICATIONS

EDUCATION

1. Bachelor’s Degree in Accounting/Finance required. 

EXPERIENCE

1. 5 or more years’ experience in healthcare finance in a reimbursement environment with cost report preparation experience - preferred.
2. Working with project teams as they relate to reimbursement analysis - preferred.
3. Strong skills and familiarity with using advanced Excel functions for analysis of large data sets - required.
4. Basic knowledge of CPT/HCPC and Revenue codes as they relate to reimbursement - preferred.