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Beacon Health System · 1 day ago

Reimbursement Analyst

Granger, IN

Full-time

Onsite

Mid Level

3+ years exp

Beacon Health System is dedicated to delivering outstanding care and inspiring health. The Reimbursement Analyst will ensure that reimbursement and case mix transactions comply with CMS, state, and contractual requirements while preparing analyses of reimbursement changes and maintaining accurate reimbursement information.

FitnessHealth Care

Responsibilities

Reviewing 835 files for errors and researching or problem solving for any errors found

Preparing and updating month end contractual analysis for general ledger reporting

Preparing analysis of the impact of proposed reimbursement changes for governmental and commercial payors

Programming computer reports from the Health System’s financial, payroll and third party billing systems, as needed to be utilized in the reimbursement analysis process and reporting to Beacon Health System's Managed Care Department

Preparing monthly transaction code and accounts receivable reports for review

Maintaining accurate reimbursement tables in the various reimbursement software programs

Setting up contracts and governmental payor reimbursement on applicable software for contract and denial management and updating as contracts or reimbursement change

Testing software prior to updates or new version installation to insure accuracy as related to reimbursement and contractual calculations

Maintaining statistical worksheets

Preparing support worksheets for cost report and wage index sections

Contacting other departments to obtain necessary information

Ensuring that information is received and inputted into the cost report software program in a timely manner

Maintaining cost report files and ensuring that appropriate cost report software updates are installed

Assisting in the preparation of both Medicare and Medicaid cost report appeals of prior year findings by researching and documenting the appropriate information in the approved CMS format

Prepares work papers to support applicable third party labor for inclusion in wage index, inclusive of contacting third parties for necessary information

Preparing related work papers as requested

Answering auditor questions and researching issues as they arise

Obtaining requested information and document copies

Writing computer reports from PeopleSoft, PIC and McKesson as required by other departments

Preparing reports for information as requested by the Manager of Reimbursement and other management staff

Prepares reimbursement analysis for specific requests

Completing other job-related assignments and special projects as directed

Designs and creates reports from computer systems to analyze accounts receivable data and costs versus reimbursement for services provided

Attends and participates in department meetings and is accountable for all information shared

Completes mandatory education, annual competencies and department specific education within established timeframes

Completes annual employee health requirements within established timeframes

Maintains license/certification, registration in good standing throughout fiscal year

Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department

Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self

Adheres to regulatory agency requirements, survey process and compliance

Complies with established organization and department policies

Available to work overtime in addition to working additional or other shifts and schedules when required

Qualification

Medicare/Medicaid knowledgeCost report preparationSpreadsheet software (Excel)Healthcare reimbursement experienceAnalytical skillsInterpersonal skillsCommunication skillsProblem-solving skills

Required

Bachelor's degree in Business Administration with a concentration in Accounting, Finance or other related field

Minimum of three years of experience in the healthcare reimbursement and cost accounting field

Demonstrates professional knowledge of the accounting process

Requires advanced knowledge of Medicare/Medicaid and managed care payment systems, as well as technical cost report issues

Requires the ability to operate a personal computer and utilize a spreadsheet software program (i.e., MS Excel)

Requires the analytical skills necessary to program reports from the Hospital data base, using specialized software; analyze financial data extracted and develop reports

Demonstrates the interpersonal and communication skills (both verbal and written) necessary to elicit cooperation and support from others and to interact tactfully and effectively with co-workers, management staff and other external contacts, in a clear, concise manner

Demonstrates knowledge of and a commitment to Beacon Health System's mission and values; and the organization's goal of providing exceptional patient experiences by following the Performance Essentials