Apply on Employer Site

Veterans in Healthcare · 2 months ago

Senior Government Reimbursement Analyst - Finance Operations

Los Angeles, CA

Full-time

Onsite

Mid, Senior Level

$96K/yr - $158K/yr

3+ years exp

Veterans in Healthcare is seeking a Senior Government Reimbursement Analyst to support governmental reporting and reimbursement. The role involves preparing Medicare and Medicaid Cost Reports, analyzing payment methods, and ensuring compliance with regulatory changes while collaborating with various teams.

Health CareMilitary

Responsibilities

Support the preparation and submission of all Medicare, Medi-Cal and Tri-Care cost report filings and amendments on behalf of Keck Medicine of USC, home office and its hospitals. Review statistical, financial, and departmental data for accuracy and compliance with CMS and state regulations escalating discrepancies to the Manager as needed

Maintain detailed records of audits, data requests, auditor sampling, responses, and appeals. Review audit adjustments for accuracy and update internal reporting processes. Identify potential items for formal Medicare appeal and provide recommendations to the Manager for operational improvements based on audit findings

Prepare Medicare Cost Report (MCR)-related journal entries and balance sheet reconciliations. Support monthly settlement account estimates, related analysis, and third-party audits. Generate ad hoc reports to assist with institutional monthly financials. Respond to inquiries and other requests for information, escalating complex issues to the Manager as needed

Monitor and interpret CMS, Medicare, and Medicaid reimbursement, including proposed and final IPPS and OPPS rules, CMS bulletins, and related litigation. Summarize key updated and provide concise briefings to the Manager and reimbursement leadership

Partner with Finance, Revenue Cyle, and third-party vendors to collect and validate data for reimbursement-related activities, including Medicare bad debt, and DSH reporting. Provide analytical support and insights to Manager on reimbursement impacts and compliance

Perform other duties as assigned by the Manager to support the reimbursement function and broader departmental goals

Qualification

Hospital reimbursementMedicare Cost ReportCMS regulationsGAAP accountingHealthcare financial reportingAnalytical skillsProject planningMicrosoft OfficeCommunication skillsOrganizational skillsProblem-solving skills

Required

Bachelor's Degree in Finance, Health Administration, Business, Accounting or related field

3 years hospital reimbursement, with a strong focus on government payers including Medicare and Medicaid

Experience with CMS and state Medicaid hospital payment systems and cost reporting requirements

Experience with Medicare and Medicaid reimbursement guidelines including audits and appeals processes

Strong analytical, organizational, and communication skills

Sound business judgment and creative problem-solving attributes

Experience in GAAP and healthcare financial accounting/reporting consolidation processes

Demonstrate skills in project planning, reviewing, and ensuring work is organized and documented

Working knowledge of Hospital Revenue Cycle (Patient accounting, collections, denials, etc.) and related reporting

Proficiency with Microsoft Office (i.e., Excel, Word, PowerPoint)

Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)