SR REIMBURSEMENT ANALYST

                                                                             **This is a 100% remote work-from-home position**

Are you looking to propel your career in hospital reimbursement to new heights with an organization that's deeply committed to your growth and success? Premier Health is searching for a Senior Reimbursement Analyst with a passion for financial accuracy and a drive to make a meaningful impact in the healthcare sector. Imagine being part of a team that values your expertise and supports your professional journey every step of the way. At Premier Health, we pride ourselves on being a beloved employer with a track record of fostering a workplace where employees genuinely enjoy coming to work, feel deeply connected to their contributions, and are part of making a significant difference in the healthcare industry. This role offers you the unique opportunity to enhance your skills, work on challenging and rewarding projects, and be a pivotal part of our mission to provide exceptional care to the community.

Responsibilities

 

• Prepare Medicare and Medicaid cost reports and Tricare capital and direct medical education reports.
• Collect and analyze data for government cost report schedules including but not limited to Medicare cost report Worksheet S-10, Medicaid DSH eligibility, Medicare bad debt, and wage index.
• Work with external auditors to validate financial statement information and third-party cost reports.
• Calculate monthly accounts receivable and third-party reserves including submission of monthly journal entries.
• Assist in annual net revenue budget and three-year forecasting processes.
• Review CMS/MAC rate reviews and cost report settlements.
• Prepare and submit reports, logs, and documentation for various federal and state compliance requirements.
• Prepare detailed reimbursement impact analyses.
• Act as liaison between Reimbursement and the IT report writing teams.
• Maintain up-to-date knowledge of Medicare, Medicaid, and other regulations, and participate in the promotion of PHP's financial stability.

Requirements

 

• Bachelor’s Degree in Accounting, Business Administration, Finance, or related field.
• 3-5 years of job-related experience, hospital reimbursement experience including Medicare and Medicaid cost report experience required.
• Preferred experience in Medicare medical education reimbursement (IME/DGME).
• Current working knowledge of the financial statement process, running ad-hoc patient financial system and/or general ledger financial reports, and strong financial skills required.
• Expertise in Windows, Microsoft Excel, Microsoft Word, and HFS.
• Strong written and verbal communication skills.
• Ability to prioritize and manage multiple projects simultaneously.
• Proactive and independent work style, with the ability to also work effectively in a team.  
• Compliance with organization’s policies and regulatory standards.

Benefits

 

• Remote – flexible working arrangements
• Comprehensive health, vision, and dental insurance
• Generous TOP (Time-Off-Program) paid vacation, and holiday schedule
• Professional development and continuing education opportunities
• Employee wellness programs

• Retirement plan options – 401(k) and pension

 

If you are eager to advance your career while making a real difference in the healthcare community, Premier Health is the ideal place for you. We invite you to bring your knowledge, experience, and passion to a team that values your contributions and is committed to your professional growth. Don't miss out on this opportunity to join a team of dedicated professionals who love what they do. Apply now to become part of the Premier Health family!

 

 

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The Senior Reimbursement Analyst will be responsible for preparing the Medicare and Medicaid cost reports, completing the monthly contractual allowances, and assisting in the annual contractual budget and forecasting processes.  The Senior Reimbursement Analyst will work with internal and external auditors in validating information as reported on the financial statements and third party cost reports.  The analyst should have a thorough knowledge of federal and state rules and regulations.

 

 

       Essential Duties & Functions:

§ Collects and analyzes all underlying data, prepares all supporting workpaper documentation, and submits in a timely manner all governmental cost report schedules along with the submission of the Medicare cost reports, Medicaid cost reports, and Tricare capital and direct medical education reports.  Requires strong knowledge of IME and DGME reimbursement related to the Medicare cost report.  Follows governmental regulations when preparing these reports.

§  Collects, analyzes all underlying data and prepares supporting documentation for:

o   the Medicare cost report Worksheet S-10.  Reviews outside consultant logs and schedules.  Reviews audit adjustments for accuracy.

o   the Medicare cost report Medicaid DSH eligibility.  Prepares additional provider research files and reviews outside consultant logs.

o   the Medicare cost reports Traditional Medicare Bad Debt and Dual Eligible logs.

o   the Medicare cost report Wage Index.  Reviews audit adjustments for accuracy.

§  Prepares the calculation of accounts receivable and third-party reserves including the timely submission of the monthly journal entry along with additional analyses as needed.

§  Collects and analyzes all underlying data and prepares the Medicaid pending conversion calculations.

§  Prepares 340 B trial balances for inclusion with the annual HRSA submissions.

§  Prepares Medicare gain/loss analysis for Schedule H of Form 990.

§  Assists in the annual net revenue budget and three-year forecasting process.  Research and completion of all governmental modeling is the primary focus. 

§  Assists with the preparation of E&Y audit workpapers.

§  Reviews CMS/MAC rate reviews and audit adjustments for accuracy.

§  Prepares amended Medicare and Medicaid cost reports and Tricare capital and direct medical education reports and supporting schedules as needed.

§  Reviews tentative cost report settlements and final cost report settlements including audit adjustments for accuracy.

§  Prepares Medicare and Medicaid reimbursement factors and reimbursement calculators for Inpatient, Outpatient, Psych, and Rehab.

§  Collects and analyzes all underlying data in conjunction with the Rehab Unit and prepares the submission for the Inpatient Rehab Unit 75% compliance report for exemption from the Inpatient Prospective Payment System.

§  Collects and analyzes all underlying data, prepares all supporting documentation, and submits in a timely and accurate manner the Medicare occupational mix surveys.  Reviews audit adjustments for accuracy.

§  Prepares HCAP logs and obtains supporting documentation for independent consultant review.  Also, prepares the matching data in the formats used for the Medicaid cost report.

§  Prepares Myers & Stauffer logs for the federal DSH audits that match the Medicaid cost report in the required format in a timely and accurate manner.

§  Submits documentation for the Kentucky Workers’ Compensation Hospital Fee Schedule cost-to-charge ratio calculation.

§  Collects all underlying data, prepares detail and summary invoices, and payment reconciliations for the Montgomery County Indigent Ill Levy submissions.

§  Acts as a liaison between Reimbursement and the report writing team to assist in regulatory data revisions.

§  Prepares detailed analysis of regulatory changes to determine the reimbursement impact to PHP.

§  Ensures compliance with Federal and State laws when using PHP provider numbers, including Provider Based Status rules.

§  Maintains current working knowledge of Medicare, Medicaid, and other regulations.  Assists in providing education with Federal rules and regulations.