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DCH Health System · 2 months ago

Senior Reimbursement Analyst

US-AL-Tuscaloosa

Full-time

Onsite

Mid, Senior Level

2+ years exp

DCH Health System is a healthcare provider seeking a Senior Reimbursement Analyst. The role involves preparing and filing various cost reports, interpreting federal guidelines, and ensuring compliance with reimbursement regulations.

Health CareHospitalMedical

Responsibilities

Prepare work papers, enter data and file the cost reports for the Health System. Ensures reports are prepared in advance for a thorough review and that all reports are filed timely with governing authorities

Analyst should understand basic accounting principles and how to prepare journal entries associated with cost reports and other accounting processes within the department

Monitor and interpret Federal and State reimbursement regulations, maintain proficiency in using the Federal Register, and maintain a thorough working knowledge of all payer reimbursement principles and regulations

Identify and assist with the implementation of strategic reimbursement initiatives. Assist with financial analysis of new and existing programs related to governmental reimbursement calculations, issues and projections

Accurately prepare the System Home Office cost report and files within stated deadlines

Prepare and respond to audits with management oversight from federal or state intermediaries and agencies on open cost reports

Completes the Medicare Intern and Resident Information System (IRIS) file

Assist in the preparation of the IME GME filings

Administrator of DocTime log software that tracks both physician medical director and other administrative hours. Sets up new physician users and provides training

Computes monthly receivables/payables and prepares journal entries to record the adjustments. Reconciles Medicare periodic interim payments (PIP) to the general ledger and the monthly Medicare receivable/payable schedule

Computes reimbursement rates for all payers including those for Medicare IPPS, Medicare SNF, Medicare Inpatient Rehab, and Medicare Inpatient Psych. Analyst should have an understanding of reimbursement and billing practices for other commercial and HMO plans

Periodically reconciles commercial insurance claim payments that are based on a methodology similar to or including Federal government reimbursement principles

Compiles the annual workman's compensation data request used for the annual rate setting

Performs quarterly cash audits

Performs monthly operating reviews with department heads and assists in budget completion with assigned departments

Prepares business pro formas for new strategic objectives and service line reviews

Prepares wage index projections when CMS releases its proposed and final rules

Prepares reconciliation of UCP from Final Notice to Cost Report Reconciliation

Works with vendors on special reimbursement initiatives

Completed Medicaid Assister program reporting

Analyze DRG and APC impact changes

Prepares low-volume adjustments

Basic understanding of cost accounting and the method in which costs are allocated in the cost accounting system

Qualification

Cost report preparationFederal reimbursement regulationsAccounting principlesFinancial analysisMedicare reimbursement knowledgeDocTime log softwareIndependent workerPassion for changeEffective communication

Required

Bachelor's Degree in Accounting, Business, Finance or Healthcare Administration

Must be able to work independently

Must be able to read, write legibly, speak, and comprehend English

Must have a passion for change and identifying better ways to do things

Must be an effective communicator and independent worker who will be an industry leader in changing how data and analytics is configured, delivered, and supported

Two to Four Years of Accounting or Finance Experience

Two years in an analyst role

Prior experience completing cost reports for government programs

Expertise in reading and interpreting federal guidelines associated with filing cost reports

Understanding of basic accounting principles and how to prepare journal entries associated with cost reports and other accounting processes

Ability to monitor and interpret Federal and State reimbursement regulations

Ability to maintain proficiency in using the Federal Register

Ability to maintain a thorough working knowledge of all payer reimbursement principles and regulations

Ability to prepare work papers, enter data and file the cost reports for the Health System

Ability to prepare and respond to audits with management oversight from federal or state intermediaries and agencies on open cost reports

Ability to compute monthly receivables/payables and prepare journal entries to record the adjustments

Ability to reconcile Medicare periodic interim payments (PIP) to the general ledger and the monthly Medicare receivable/payable schedule

Ability to compute reimbursement rates for all payers including those for Medicare IPPS, Medicare SNF, Medicare Inpatient Rehab, and Medicare Inpatient Psych

Ability to periodically reconcile commercial insurance claim payments

Ability to compile the annual workman's compensation data request used for the annual rate setting

Ability to perform quarterly cash audits

Ability to perform monthly operating reviews with department heads and assist in budget completion with assigned departments

Ability to prepare business pro formas for new strategic objectives and service line reviews

Ability to prepare wage index projections when CMS releases its proposed and final rules

Ability to prepare reconciliation of UCP from Final Notice to Cost Report Reconciliation

Ability to work with vendors on special reimbursement initiatives

Ability to complete Medicaid Assister program reporting

Ability to analyze DRG and APC impact changes

Ability to prepare low-volume adjustments

Basic understanding of cost accounting and the method in which costs are allocated in the cost accounting system