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ECU Health · 6 hours ago

Sr. Reimbursement Analyst

United States

Full-time

Remote

Senior Level

5+ years exp

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The Senior Reimbursement Analyst is responsible for the integrity of net revenue, providing cost report preparation, audit preparation, and ensuring compliance with Medicare and Medicaid regulations.

Hospital & Health Care

Responsibilities

Prepares interim estimates and annual cost reports for Medicare, Medicaid and other State or Federal agencies for ECU Health facilities. Proficient in the use of Cost Report software

Prepares, monthly reserve models and provides thorough analysis of net revenue variances for assigned entities to include, bad debt and other revenue adjustments in accordance with ECU Health policies and procedures. Prepares Third Party Settlement estimates and maintains reconciliation of related balance sheet accounts. Analyzes and reports changes in monthly reserves. Investigates and makes recommendations for updates to assumptions and/or methodology

Provides projections and analytical support during fiscal year budgeted net revenue preparation

Assists in the maintenance of standardized policies and procedures for the Reimbursement Department. Reviews operational reports, identifies opportunities/problems, and makes recommendations for improving processes methodologies. Trains reimbursement analysts in the department on new responsibilities

Coordinates the Medicare, Medicaid and other State or Federal agency cost report audits, providing supporting documentation, reviewing audit adjustments, and responding to audit findings in a timely and efficient manner

Maintains working knowledge of NC Medicaid Programs to include but no limited to HASP, Direct and Enhanced Payments. Records appropriate entries to the applicable ECU facilities for payments received. Completes schedules as required by the state of NC

Maintains working knowledge of net revenue software and works with IT/Vendors to ensure information is updated timely to accurately record net revenue at ECU Health Entities. Extracts and processes data to support review of net revenue

Maintains working knowledge of Indirect and Direct Medical Education and provides request reimbursement analysis on Program Changes

Supports ECU Health Financial Statement audit as it pertains to Net Revenue. Provides support for balance sheet reserves and estimates. Performs analysis for variance inquiries

Completes special projects as required

Qualification

Medicare experienceMedicaid experienceReimbursement regulationsCost report preparationNet revenue analysisCustomer satisfactionProcess improvementTeam training