WVUH Specialty Pharmacy & Home Infusion · 3 months ago
Senior Reimbursement Analyst - Net Revenue
United States
Full-time
Remote
Senior Level
5+ years expWVUH Specialty Pharmacy & Home Infusion is part of the West Virginia University Health System, and they are seeking a Senior Reimbursement Analyst. This role is responsible for managing reimbursement processes, including filing cost reports, handling audits, and training new analysts, while requiring advanced Excel skills and effective communication with various departments.
Hospital & Health Care
Responsibilities
Prepare the annual cost reports for Medicare, Medicaid and TRICARE in accordance with government regulations. Analyze reports for increased reimbursement with an understanding of CCR and their impact on reimbursement
Primary contact on assigned hospital audits, work diligently to minimize reimbursement impact to hospital
Assessing the monthly cost estimate for necessary changes or material variances relating to hospital operations throughout the year. (CAH only)
Prepare annual Reimbursement Budget models on assigned hospitals with accuracy using final regulations, and Strata revenue and statistical reports. Serves as a resource to the Reimbursement team
Coordinates the completion and preparation of the annual Uniform Report (UFR) for the WV Healthcare Authority. Serves as a resource to the Reimbursement team
Understanding of Method II reimbursement and the impact on payments and deductions. (CAH only)
Understanding of IME/GME, DSH, RHC, bad debts and other medical education programs
Look for opportunities to automate and improve current processes with a goal of increasing accuracy and efficiency
Analyze monthly contractual reserve estimates and communicate to management material changes to A/R. Prepare journal entries
Assist with the training of new analysts on department procedures and systems
Prepare Medicaid DSH survey and template for DSH Audits. Also, responsible for the review of DSH audit adjustments for accuracy
Primary contact on Wage Index and Occupational Mix audits. Review proposed adjustments from auditors and PUF files for accuracy. (Acute only)
Update third party reserves and review monthly supplemental and pass through schedules for accuracy. Prepare necessary journal entries
Verify and analyze interim rate calculations and final settlements by third party payer for accuracy. Responsible for distributing updated rates to internal departments
Promotes and contributes positively to the department by assisting with team members’ questions, contributing ideas and problem solving
Takes a leadership role in performance improvement through planning and implementing change; maintaining and improving productivity through attendance; and participation in staff meetings, committee meetings and cross functional group projects
Qualification
Required
Bachelor's Degree in business administration, accounting, or finance
Five (5) years' of experience in finance or accounting
Advance Excel skills/knowledge is needed in this role
Ability to handle multiple tasks and see each to completion with minimal supervision
Effective communication skills to interact with various departments
Preferred
Advanced degree or Certification in accounting, finance, or healthcare administration
Experience working in a health care or health system environment
Experience working with CMS and/or Medicare auditors
Experience with EPIC, Workday, Lawson, Strata Jazz and TOYON Absolute software
Advanced computer and spreadsheet skills, primarily in Excel
Company
WVUH Specialty Pharmacy & Home Infusion
WVUH Specialty Pharmacy & Home Infusion
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase