Reimbursement Analyst- Pawleys Island, SC

Responsibilities

Position Summary: The Reimbursement Analyst will ensure timely and accurate reporting of all regulatory financial information to Medicare & Medicaid.  This position requires the ability to manage strict deadlines, work independently and own one’s work product. 

Specific duties include:

• Prepare various required regulatory submissions. This includes but is not limited to:  IRS Form 990 Schedule H; Medicare, Medicaid & Tricare Cost Reports; Medicaid DSH; Joint Annual Reports.
• Coordinate and manage external audits from Medicare & Medicaid as necessary.
• Prepare monthly contractual allowance models across all entities. Review and analyze for reasonableness and determine significant drivers of variances to budget and historical trends.
• Assist with preparation of the annual net revenue operating budget through the gathering of data and use of various budgeting/forecasting tools.
• Perform net revenue analysis as requested by the organization. Examples include:  service line revenue estimates, payer contract related revenue analysis, etc.
• Update and analyze payor contract information to perform reimbursement modeling.
• Ensure compliance with applicable laws and regulations and conduct business in an ethical and professional manner.
• Update and maintain job knowledge through educational opportunities, development of professional networks and participation in professional organizations.
• Contribute to departmental and organizational special projects as assigned.

Qualifications

Education:

• Bachelor’s degree in Accounting, Finance or Business Administration required.

Experience: 

Required:

• At least 5 years of progressive healthcare experience working as a Reimbursement Analyst in a hospital, a Medicare Administrative Contractor (MAC), and/or a professional audit or consulting firm focusing on cost reporting and healthcare reimbursement.

Knowledge/ Skills:

• Strong organizational skills and attention to detail required.
• Strong verbal and written communication skills required.
• Proficiency with Microsoft Office (including Word, Excel, Outlook & Powerpoint).
• Ability to work independently or in a team setting.
• Able to multitask and manage strict deadlines.
• Ability to apply critical thinking skills on a regular basis.

Physical Requirements: Light-Medium

While performing the duties of this job, the employee is frequently (activity or condition exists from 1/3 to 2/3 of the time) required to stand, sit, and walk; frequently to use hands, fingers; and frequently to talk or hear. The employee must exert 15 to 20 pounds of force occasionally (activity or condition exists up to 1/3 of the time), and/or 5 to 10 pounds of force frequently, and/or greater than negligible up to 5 pounds of force constantly to move objects.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.