Analyst, Reimbursement III

Park Nicollet Health Services; BLOOMINGTON (MN); On-site; USD 85,000 - 110,000; Full time

Job summary

HealthPartners is hiring a Reimbursement Analyst III. The role involves preparing hospital, hospice, home health agency, home office and SNF cost reports, supporting external audits related to net revenue valuation, net accounts receivable valuation, and pay or settlement liabilities.

The position also maintains decision support system reimbursement modeling and audits, and conducts analyses related to patient services, regulatory issues and general accounting.

Qualifications

• Education: Bachelor’s degree in Accounting or Finance.
• Experience: 3-5 years of experience in Medicare cost reporting or related healthcare finance area.

Responsibilities

• Evaluation of Net Patient Services Revenue and Accounts Receivable.
• Monthly analysis and valuation of net patient services revenue.
• Interim updating of Medicare and third party settlement liabilities.
• Quarterly evaluation of net patient accounts receivable and adjustments.
• External Audit resource for documentation needed to audit net patient revenue and net patient accounts receivable valuation.
• Medicare Cost Report Preparation and Audit Support.
• Prepare cost reports for Regions and HealthPartners affiliates.
• Assist the Reimbursement Manager with Medicare audit support as needed.
• Assist the Reimbursement Manager with the preparation of Medicare appeal.
• Documentation and position paper preparation as needed.
• Decision Support System Modeling and Analysis: Modeling of Net Revenue Reimbursement for Medicare & Medicaid.
• Auditing of Decision Support System reimbursement and costing.
• Analysis of regulatory and program changes using decision support system.
• Other Regulatory Reporting: Filing of annual Department of Health Hospital Annual Report based on existing State of Minnesota regulations.
• Filing of annual Department of Health Medical Education and Research Cost grant application based on existing State of Minnesota regulations.
• Completion of trade association survey data related to patient services revenue and statistical data available from regular analytical records.
• Preparation of annual net patient services revenue budget and associated other operating revenues.
• Preparation of assumption driven inpatient and outpatient gross revenue contractual allowance and net patient services revenue budget based on historical data and business volume changes as communicated by management direction.
• Prepare analysis for mid year forecasting of net revenue

Skills

Hospital accounting

Medicare cost accounting

Communication skills

Confidentiality

Excel

Cost report software

Decision support modeling

Independent work

Payor relationships

Education

Bachelor's degree in Accounting or Finance

Tools

Microsoft Office

Excel

PowerPoint

Cost report software

Job description

Job Description

HealthPartners is hiring a Reimbursement Analyst III.

The Reimbursement Analyst III is responsible for the preparation of hospital, hospice, home health agency, home office and skilled nursing facility cost reports, support for annual external audit related to net revenue valuation, net accounts receivable valuation, and pay or settlement liabilities. This position is also responsible for maintaining decision support system reimbursement modeling and auditing of same to ensure that calculated net revenues reasonably match actual payments. Other special analysis related to patient services, government regulatory issues and general accounting as assigned.

Minimum Qualifications

• Education: Bachelor’s degree in Accounting or Finance


• Experience: 3-5 years of experience in Medicare cost reporting or related healthcare finance area


• Licensure/Registration/Certification: None

Knowledge, Skills And Abilities

• Advanced knowledge of hospital accounting and Medicare cost accounting fundamentals


• Knowledge of accounting, statistics and general business principles and practices


• Ability to maintain effective working relationships with others


• Ability to communicate effectively both written and oral


• Ability to handle confidential information with discretion


• Ability to use a personal computer (Microsoft Office, Excel, PowerPoint) and cost report preparation software


• Ability to work independently with light supervision


• Advanced knowledge of third party reimbursement payment mechanisms and settlement procedures


• Knowledge of hospital payor relationships and accounting

Major Job Duties And Tasks

• Evaluation of Net Patient Services Revenue and Accounts Receivable (10%)


• Monthly analysis and valuation of net patient services revenue


• Interim updating of Medicare and third party settlement liabilities


• Quarterly evaluation of net patient accounts receivable and adjustments


• External Audit resource for documentation needed to audit net patient revenue and net patient accounts receivable valuation


• Medicare Cost Report Preparation and Audit Support (50%)


• Prepare cost reports for Regions and HealthPartners affiliates


• Assist the Reimbursement Manager with Medicare audit support as needed


• Assist the Reimbursement Manager with the preparation of Medicare appeal


• Documentation and position paper preparation as needed


• Decision Support System Modeling and Analysis (10%)


• Modeling of Net Revenue Reimbursement for Medicare & Medicaid


• Auditing of Decision Support System reimbursement and costing


• Analysis of regulatory and program changes using decision support system


• Other Regulatory Reporting (20%)


• Filing of annual Department of Health Hospital Annual Report based on existing State of Minnesota regulations


• Filing of annual Department of Health Medical Education and Research Cost grant application based on existing State of Minnesota regulations


• Completion of trade association survey data related to patient services revenue and statistical data available from regular analytical records


• Preparation of annual net patient services revenue budget and associated other operating revenues (10%)


• Preparation of assumption driven inpatient and outpatient gross revenue contractual allowance and net patient services revenue budget based on historical data and business volume changes as communicated by management direction


• Prepare analysis for mid year forecasting of net revenue