Sr. Reimbursement Analyst

Customer Success ManagerCustomer SuccessFull TimeRemoteTeam 10,001

Location

United States

Posted

12 days ago

Salary

Not specified

No structured requirement data.

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

This is a 100% remote work-from-home position.

  • Collects, analyzes all underlying data and prepares supporting documentation for the Medicare cost report Worksheet S-10.
  • Reviews outside consultant logs and schedules.
  • Reviews audit adjustments for accuracy.
  • Prepares additional provider research files and reviews outside consultant logs for the Medicare cost report Medicaid DSH eligibility.
  • Prepares the Medicare cost reports Traditional Medicare Bad Debt and Dual Eligible logs.
  • Prepares the Medicare cost report Wage Index and reviews audit adjustments for accuracy.
  • Prepares the calculation of accounts receivable and third-party reserves including the timely submission of the monthly journal entry along with additional analyses as needed.
  • Collects and analyzes all underlying data and prepares the Medicaid pending conversion calculations.
  • Prepares 340 B trial balances for inclusion with the annual HRSA submissions.
  • Prepares Medicare gain/loss analysis for Schedule H of Form 990.
  • Assists in the annual net revenue budget and three-year forecasting process.
  • Research and completion of all governmental modeling is the primary focus.
  • Assists with the preparation of E&Y audit workpapers.
  • Reviews CMS/MAC rate reviews and audit adjustments for accuracy.
  • Prepares amended Medicare and Medicaid cost reports and Tricare capital and direct medical education reports and supporting schedules as needed.
  • Reviews tentative cost report settlements and final cost report settlements including audit adjustments for accuracy.
  • Prepares Medicare and Medicaid reimbursement factors and reimbursement calculators for Inpatient, Outpatient, Psych, and Rehab.
  • Collects and analyzes all underlying data in conjunction with the Rehab Unit and prepares the submission for the Inpatient Rehab Unit 75% compliance report for exemption from the Inpatient Prospective Payment System.
  • Collects and analyzes all underlying data, prepares all supporting documentation, and submits in a timely and accurate manner the Medicare occupational mix surveys.
  • Prepares HCAP logs and obtains supporting documentation for independent consultant review.
  • Prepares the matching data in the formats used for the Medicaid cost report.
  • Prepares Myers & Stauffer logs for the federal DSH audits that match the Medicaid cost report in the required format in a timely and accurate manner.
  • Submits documentation for the Kentucky Workers’ Compensation Hospital Fee Schedule cost-to-charge ratio calculation.
  • Collects all underlying data, prepares detail and summary invoices, and payment reconciliations for the Montgomery County Indigent Ill Levy submissions.
  • Acts as a liaison between Reimbursement and the report writing team to assist in regulatory data revisions.
  • Prepares detailed analysis of regulatory changes to determine the reimbursement impact to PHP.
  • Ensures compliance with Federal and State laws when using PHP provider numbers, including Provider Based Status rules.
  • Maintains current working knowledge of Medicare, Medicaid, and other regulations.
  • Assists in providing education with Federal rules and regulations.

Qualifications

  • Bachelor's Degree in Business Administration majoring in Accounting, Finance or related business field required.

Requirements

  • 3-5 years of job-related experience required.
  • Hospital reimbursement required, including Medicare and Medicaid cost report experience required.
  • Current working knowledge of the financial statement process, running ad-hoc patient financial system and/or general ledger financial reports, and strong financial skills required.

Preferred Experience

  • Experience in Medicare medical education reimbursement (IME/DGME) and Medicare provider enrollment system (PECOS).

Job Requirements

  • Bachelor's Degree in Business Administration majoring in Accounting, Finance or related business field required.
  • 3-5 years of job-related experience required.
  • Hospital reimbursement required, including Medicare and Medicaid cost report experience required.
  • Current working knowledge of the financial statement process, running ad-hoc patient financial system and/or general ledger financial reports, and strong financial skills required.
  • Preferred Experience
  • Experience in Medicare medical education reimbursement (IME/DGME) and Medicare provider enrollment system (PECOS).

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