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Company

Original Job Post

Pine Rest Christian Mental Health Services · 4 days ago

Senior Reimbursement Analyst

Grand Rapids, MI

Full-time

Onsite

Senior Level

5+ years exp

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Responsibilities

Prepares and compiles Medicare and Medicaid cost reports as required by the federal and state laws and other third-party contractors.

Oversee the monthly contractual allowance and reserve analysis for all payers such as Medicaid, Medicare, BCBS, and other managed care contracts.

Responsible for preparation and review of third-party report filings, including (annual) cost reports, appeals and payment calculations.

Prepares and compiles Medicare and Medicaid cost reports as required by the federal and state laws and other third-party contractors.

Responsible for annual budget for third-party contractual allowances.

Works closely with the CFO in administering the annual budget process and fully responsible for development and maintenance of the budget system so that it meets the operational needs of all users.

Assures accurate and timely calculation of contractual allowances and all other related month-end and year-end closing tasks.

Completes monthly analysis of contractual and bad debt allowance accounts, including comparisons to the prior month and to budget.

Responsible for the maintenance and development of payment factors, costing ratios and reporting formats.

Perform variance analysis of third-party liability.

Work closely with various stakeholders to ensure accuracy in estimates of contractual allowances and reserves on all critical and high cost accounts for month-end close.

Develop strategies to maximize reimbursement and limit exposure to billing and coding compliance issues.

Collaborate with key personnel in Patient Accounts and Managed Care departments to ensure accurate and timely resolution to third party financial reporting

Supports third party contract negotiations through detailed analysis of activity, related costs and charges, and assess the impact of managed care contracts on reimbursement and contractual allowances.

Responsible for the review of interim and annual financial statement reporting for patient service revenue and revenue deductions, charity care, bad debt and any other third-party related adjustments.

Responsible for the proper reporting of net revenue and ability to coordinate with the external audit team for proper reserve methodology.

Responsible for the preparation of client prepared audit schedules and supporting documentation related to the interim and fiscal year-end audit of contractual allowances, reserves and settlements.

Assist in preparing the annual budget for patient service revenue and revenue deductions, charity care, bad debt and any other third-party related adjustments.

Maintain and oversee the Master Payer report used for completing surveys, preparing various Audit schedules, annual budget and projections and the analysis of accounts receivables.

Manages internal financial reporting for key organizational stakeholders.

Prepare key monthly financial reports, including but not limited to third party reserves schedules, net accounts receivable by payer schedule, and various other reports for distribution to key stakeholders.

Assists in various phases of annual independent audit by Certified Public accounting firm as well as review of third-party contractual allowances.

Responsible for preparation of monthly financial reimbursement model for monthly accounting closes. Interacts with CFO and Director of Finance.

Promotes quality service through problem-solving skills that foster positive communication and interpersonal relationships with organization leadership and staff.

Provides guidance and support to other team members in Finance and Patient Accounts.

Support month-end and year-end close process.

Responsible to uphold the healing ministry of Christ through relationships that honor integrity, stewardship, empowerment, the promotion of diversity and professional excellence.

Must maintain annual training and demonstrate competency in the required programmatic training.

Performs other duties or functions as assigned.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Healthcare financeFinancial statementsCost report preparationAd-hoc reportsMedicareMedicaidGeneral ledgerMonth-end closeGreat PlainsManagement ReporterFRX ForecasterMicrosoft ExcelMicrosoft WordAccounting proceduresBusiness trendsQuantitative skillsProject coordinationProblem-solvingHard-workingCommunicationTeamworkGeneral Ledger FunctionsReimbursement Environment

Required

Bachelor’s degree in Accounting, Finance or equivalent required.

5 or more years’ experience in healthcare finance in a reimbursement environment.

Experience with creating financial statements and cost report preparation and/or month-end contractual experience.

Experience in running ad-hoc reports preferred, Medicare and Medicaid cost report experience required.

Experience with general ledger functions and the month-end/year-end close process.

Ability to provide care/service within the scope of: Holding a conviction to express Christ’s love and compassion to recipients of services, coworkers, and surrounding communities through integrity, stewardship, empowerment, the promotion of diversity, equity, inclusion, and professional excellence.

Ability to provide culturally inclusive care with a wide range of individuals in a diverse community setting.

Excellent accounting software user and administrative skills to include Great Plains, Management Reporter and FRX Forecaster.

Windows, Microsoft Excel and Word experience & expertise required.

Strong written and verbal communication skills.

Thorough knowledge of basic accounting procedures and principles.

Awareness of business trends; ability to research, obtain and evaluate information.

Accuracy and attention to detail.

Aptitude for numbers and quantitative skills.

Ability to prioritize and coordinate multiple projects simultaneously.

Work in a collaborative and team environment.