LanceSoft, Inc. · 5 hours ago

Reimbursement Analyst

United States

Contract

Remote

Senior Level

7+ years exp

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Information Technology

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Hiring Manager

Anushka Gupta

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Responsibilities

Gathers and maintains the data used in the preparation of the Medicare and Medicaid cost reports and provides to outside consultants as necessary and reviews.

Oversees the cost report preparation performed by outside consultants and performs initial review prior leadership.

Reviews wage index and recommends adjustments

Analyzes the impact of proposed cost report changes and implements approved changes in the work papers and cost reports.

Prepares the quarterly Medicare/Medicaid cost report settlement estimates and maintains the general reserve binder for the corresponding hospital; is able to revise the models to reflect any regulation changes, as necessary.

Qualification

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Healthcare ReimbursementMedicareCost Report PreparationWage Index AnalysisAdjustmentsMedicaidData AnalysisRegulation ChangesFinancial Analysis

Required

Bachelor's Degree in Accounting, Finance or related field is required.

Must Have an understanding of complex Medicare/Medicaid reimbursement including: Interns & residents, Nursing & Allied health, Transplants, Organ Acquisition.

Various Payment methodologies: IPPS, OPPS, IPS, IRF, SNF, LTCH, MDH, SCH, etc.

Cost Report preparation.

Provider based regulations and preparing provider based attestations.

Ability to research applicable Medicare/Medicaid laws and regulations.

Experience with wage index including identifying opportunities to optimize wage index.

Experience with cost report audits.

IME/GME - Analyze GME & IME data, including but not limited to cost, residents, FTEs, Caps, and Per Resident amounts to determine accurate Medicare/Medicaid reimbursement.

Work with the IRIS data systems and GME departments to ensure accurate reporting of rotations and other resident data.

NAHE - Analyze data related to Nursing and Allied Health programs, including but not limited to training costs, resident information, rotation schedules, accreditations, etc. to ensure accurate reporting for Medicare passthrough payments and other reimbursement.

Organs - Perform periodic analyses of organ acquisition costs and organ counts to determine accurate Medicare reimbursement.

Work with the transplant and OPO departments to obtain and review data.

Minimum of 7 years of experience in healthcare reimbursement preferred.