Government Reimbursement Analyst

St. Charles Health System; United States; Remote; USD 71,000 - 107,000; Full time

Job summary

A major health care provider in the United States is seeking a Cost Report and Government Reimbursement Analyst and a Senior Analyst to manage regulatory filings and analyze reimbursement streams. Candidates should have a Bachelor's degree in accounting or finance, with relevant experience in healthcare finance. These roles support efficient reimbursement practices and collaboration across departments, ensuring compliance and accuracy in reporting.

Qualifications

• 3-5 years of experience in healthcare finance or related field, including regulatory reporting.
• Experience in consulting, multi-hospital systems, health insurer, or MAC preferred.

Responsibilities

• Prepare and analyze cost reports for Medicare, Medicaid and other agencies.
• Monitor workload and suggest efficiency improvements.
• Ensure accuracy of statutory filings.

Skills

Healthcare finance

Regulatory reporting

Analytical skills

Cost reporting

Education

Bachelor's degree in accounting or finance

Job description

Job Postings

Salary ranges and location:
Standard salary range with minimum 3 years of experience: $71,260 - $106,870/year.
Senior salary range with minimum 5 years of experience: $83,096 - $124,675/year.
Remote in Approved States with a preference for Remote Oregon. Please not apply to this role unless you currently reside in one of these states: Arkansas, Arizona, Florida, Idaho, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Oregon, Tennessee, Utah, Wisconsin

Posting 1: Cost Report and Government Reimbursement Analyst

Employer: ST. CHARLES HEALTH SYSTEM

Title: Cost Report and Government Reimbursement Analyst

Reports to: Controller

Department: Accounting

Date last reviewed: March 18, 2021

Vision: Creating America’s healthiest community, together

Mission: In the spirit of love and compassion, better health, better care, better value

Values: Accountability, Caring and Teamwork

Department Summary: The Accounting Department maintains accurate and timely financial records, supports external financial reporting and internal decision-making, and is not responsible for patient billing or charity care assessments. This role collaborates with Payer Contracting and Revenue Cycle teams.

Position Overview: The Reimbursement Analyst is responsible for preparation, coordination and management of reimbursement-related regulatory filings for Medicare, Medicaid and other governmental or nongovernmental agencies. The role analyzes government program revenue streams and financial impacts from operational and programmatic changes.

Essential Functions and Duties:

• Coordinate preparation, filing, settlement and audit of St. Charles cost reports and reimbursement-related regulatory filings for Medicare, Medicaid, and other agencies.
• Prepare/review Medicare and Medicaid cost reports and related work papers per regulations and policies.
• Manage production of state and federal cost reporting documents (annual cost reports, S-10, wage index audits) including internal resources and external experts.
• Prepare/analyze audit adjustment impacts and supply additional documentation as required by MAC or regulatory agencies.
• Review monthly workbooks and journal entries for third-party settlements, provider taxes payable and receivable; assist Accounting in staying current with regulatory changes.
• Monitor workload/methodologies and suggest efficiency or cost-saving improvements.
• Ensure timeliness and accuracy of statutory filings.
• Oversee distribution of government payer performance reports to leadership.
• Analyze reimbursement impacts of new programs, models, services and strategies; provide reports for financial objectives.
• Access rate schedules and historical claims to build model scenarios; provide visibility into key model components.
• Provide expertise to reimbursement strategies and coordinate appeals with Revenue Cycle leadership.
• Support organization values, Lean principles and maintain a safe environment.
• Maintain confidentiality and ethical standards; comply with laws, policies, and investigations as required.
• May perform additional duties of similar complexity as required.

Education: Required: Bachelor’s degree in accounting or finance. Preferred: N/A

Licensure/Certification/Registration: Required: N/A. Preferred: CPA, CHFP.

Experience: Required: Three (3) years in healthcare finance or related field, including regulatory reporting. Preferred: Experience in consulting, multi-hospital systems, health insurer, or MAC.

Personal Protective Equipment: PPE as required to perform the job safely.

Physical Requirements: Listed ranges for activity; no heavy lifting beyond 11-15 pounds except as specified.

Notes: This posting includes standard PPE and physical requirements and compliance expectations.

Expiry/Status: N/A

Posting 2: Senior Cost Report and Government Reimbursement Analyst

Employer: ST. CHARLES HEALTH SYSTEM

Title: Senior Cost Report and Government Reimbursement Analyst

Reports to: Controller

Department: Accounting

Date last reviewed: March 2024

Vision: Creating America’s healthiest community, together

Mission: In the spirit of love and compassion, better health, better care, better value

Values: Accountability, Caring and Teamwork

Department Summary: See above.

Position Overview: The Senior Cost Report and Government Reimbursement Analyst oversees preparation, coordination and management of reimbursement-related regulatory filings and analyzes government program revenue streams. Supports forecasting by developing reimbursement analyses for changes to charge master, contracts, government programs and other impacts on future reimbursement. May review work of others.

Essential Functions include similar duties with added emphasis on day-to-day analysis of reimbursement models; manages model evaluation using contract management and cost accounting systems; analyzes effects of proposed changes and provides recommendations.

• Coordinate preparation, filing, settlement and audit of cost reports and reimbursement filings for Medicare, Medicaid, and other agencies.
• Prepare/review cost reports and related work papers; manage internal/external resources for audits.
• Analyze reimbursement impacts of new programs, models, services and strategies; provide recommendations for financial objectives.
• Review audit adjustments and ensure regulatory changes are reflected in workbooks.
• Oversee timely preparation and distribution of government payer performance reports.
• Model reimbursement scenarios; use data to provide visibility into model components.
• Coordinate appeals in collaboration with Revenue Cycle leadership.
• Support Lean principles and organizational values; ensure safe, confidential handling of information.

Education: Required: Bachelor’s degree in accounting or finance.

Experience: Required: Five (5) years in healthcare finance or related field, including regulatory reporting. Preferred: Consulting experience or work in multi-hospital systems, health insurer, or MAC.

Licensure/Certification/Registration: Preferred: CPA, CHFP.

Physical/Other Requirements: PPE, and standard physical requirements; no BBP exposure.

Schedule: 40 hours per week; First Shift; Exempt; Monday-Friday; 8:00 AM - 5:00 PM.

Notes: This role supports organizational values and continuous improvement initiatives.