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Premier Health Partners · 6 hours ago

SR REIMBURSEMENT ANALYST

United States

Full-time

Remote

Mid, Senior Level

3+ years exp

Premier Health Partners is seeking a Senior Reimbursement Analyst with a focus on financial accuracy and a commitment to impacting the healthcare sector. The role involves preparing Medicare and Medicaid cost reports, working with auditors, and ensuring compliance with federal and state regulations.

CommunitiesHealth CareHospitalMedicalPersonal Health

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

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:

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

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

The Medicare cost reports Traditional Medicare Bad Debt and Dual Eligible logs

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

Qualification

Hospital reimbursement experienceMedicare cost report experienceMedicaid cost report experienceFinancial statement processMicrosoft ExcelMicrosoft WordMedicare medical education reimbursementPrioritizeAnalyze dataWritten communicationVerbal communicationInterpersonal skillsAttention to detailWork independentlyWork in a team

Required

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

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