Analyst, Reimbursement III

HealthPartners, Inc.; BLOOMINGTON (MN); Hybrid; USD 70,000 - 105,000; Full time

Job summary

HealthPartners in Bloomington, MN is hiring a Reimbursement Analyst III to support Medicare cost reporting, revenue analysis, and regulatory filings.

The role emphasizes preparing cost reports, auditing support, and modeling net revenue with focus on payor relationships and compliance with State and federal requirements.

Qualifications

• 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 PC (Microsoft Office, Excel, PowerPoint) and cost report 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.

Responsibilities

• Evaluation of Net Patient Services Revenue and Accounts Receivable (10%).
• Medicare Cost Report Preparation and Audit Support (50%).
• Decision Support System Modeling and Analysis (10%).
• Other Regulatory Reporting (20%).
• Preparation of annual net patient services revenue budget and related revenues (10%).

Skills

Hospital accounting

Medicare cost accounting

Accounting principles

Statistics

Business practices

Confidentiality

MS Office/Cost reports

Independence

Reimbursement mechanisms

Payor relationships

Education

Bachelor’s degree in Accounting or Finance

Job description

HealthPartners is hiring a Reimbursement Analyst III.

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:

1. Evaluation of Net Patient Services Revenue and Accounts Receivable (10%)
   1. Monthly analysis and valuation of net patient services revenue
   2. Interim updating of Medicare and third party settlement liabilities
   3. Quarterly evaluation of net patient accounts receivable and adjustments as required
   4. External Audit resource for documentation needed to audit net patient revenue and net patient accounts receivable valuation
2. Medicare Cost Report Preparation and Audit Support (50%)
   1. Prepare cost reports for Regions and HealthPartners affiliates
   2. Assist the Reimbursement Manager with Medicare audit support as needed
   3. Assist the Reimbursement Manager with the preparation of Medicare appeal Documentation and position paper preparation as needed
3. Decision Support System Modeling and Analysis (10%)
   1. Modeling of Net Revenue Reimbursement for Medicare & Medicaid
   2. Auditing of Decision Support System reimbursement and costing
   3. Analysis of regulatory and program changes using decision support system
4. Other Regulatory Reporting (20%)
   1. Filing of annual Department of Health Hospital Annual Report based on existing State of Minnesota regulations
   2. Filing of annual Department of Health Medical Education and Research Cost grant application based on existing State of Minnesota regulations
   3. Completion of trade association survey data related to patient services revenue and statistical data available from regular analytical records
5. Preparation of annual net patient services revenue budget and associated other operating revenues (10%)
   1. 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
   2. Prepare analysis for mid year forecasting of net revenue