Lead Provider Reimbursement Analyst - PN 20093609 (Provider Reimbursement Analyst 2)

State of Ohio; Columbus (OH); On-site; USD 36,000 - 51,000; Full time

Benefits offered by this job

Medical Coverage

Paid time off

Public retirement systems

Job summary

The Ohio Department of Medicaid in Columbus, OH seeks a Lead Provider Reimbursement Analyst to join the Sister State Agency Unit. You will review cost reports, provide guidance to analysts, and ensure accurate payment rates across multiple programs.

Responsibilities include oversight of cost reports, training staff, and staying current with ORC/OAC regulations. This is a full-time, permanent position with standard 8:00 AM–5:00 PM hours and OT eligibility.

Qualifications

• Completion of undergraduate core coursework in accounting, including auditing.
• 2 years of experience in external auditing.

Responsibilities

• Reviewing cost reports submitted to ODM for Sister State Agency and Medicaid programs.
• Acting as a lead worker, providing direction and training to Provider Reimbursement Analysts.
• Reviewing state and federal rules to establish payment rates and settlements.
• Assisting in ORC and OAC reimbursement rule revisions.
• Responding to provider and government inquiries.
• Serving as subject matter expert for cost reports and settlements in assigned program area.

Skills

Accounting and Finance

Education

Undergraduate accounting coursework

Job description

All job postings will expire at 11:59 PM Eastern Time on the application deadline.

Organization: Medicaid

Agency Contact Name and Information: [e-mail]

Work Location: 50 West Town Street
Columbus, Ohio, 43215
United States

Compensation: $31.47/hour

Schedule: Permanent - Full Time

Work Hours: 8:00AM - 5:00PM

Classified Indicator: Classified

Union: OCSEA

Overtime Status: Overtime Eligible

Primary Job Skill: Accounting and Finance

Who We Are

Investing in opportunities for Ohioans that work for every person and every family in every corner of our state is at the hallmark of Governor DeWine’s agenda for Ohio’s future. To ensure Ohio is “the best place to live, work, raise and family and start a business,” we must have strong schools, a great quality of life, and compassion for those who need our help.

Ohio Department of Medicaid plays a unique and necessary role in supporting the governor’s vision. As the single state Medicaid agency responsible for administering high-quality, person-centric healthcare, the department is committed to supporting the health and wellbeing of nearly one in every four Ohioans served. We do so by:

• Delivering a personalized care experience to more than three million people served.


• Improving care for children and adults with complex behavioral health needs.


• Working collectively with our partners and providers to measurably strengthen wellness and health outcomes.


• Streamlining administrative burdens so doctors and healthcare providers have more time for patient care.


• Ensuring financial transparency and operational accountability across all Medicaid programs and services.

What You'll Do

Office: Fiscal Operations

Classification: Provider Reimbursement Analyst 2 (PN 20093609)

Job Overview:

The Ohio Department of Medicaid (ODM) is seeking a financial professional to be part of our Sister State Agency Unit. As a Lead Provider Reimbursement Analyst, your responsibilities will include:

• Reviewing cost reports submitted to ODM for various Sister State Agency and Medicaid programs (e.g., Ohio Department of Aging, Ohio Department of Developmental Disabilities, Long-term care, Medicaid School Program, hospitals, and clinics)


• Acting as a lead worker providing direction and training to Provider Reimbursement Analysts


• Reviewing state and federal rules and regulations to establish payment rates and/or to perform interim and final settlements.


• Assisting in the Ohio Revised Code (ORC) and Ohio Administrative Code (OAC) reimbursement rule revisions


• Responding to provider and government agencies inquiries


• Acting as the subject matter expert for cost reports and settlements for assigned program area

Additional Information

The Ohio Department of Medicaid does not provide employment-based visa sponsorship.

Compensation is as listed on the posting unless required by legislation or union contract.

The work location of this position is 50 West Town Street, Columbus, Ohio 43215. You will be required to report to this work location full-time, if selected.

Travel required, as needed. Must provide own transportation. Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence.

Resumes and/or attachments are not reviewed. Therefore, please provide detail in the work experience section of your application.

Why Work for the State of Ohio

At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:

• Medical Coverage


• Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period


• Paid time off, including vacation, personal, sick leave and 11 paid holidays per year


• Childbirth, Adoption, and Foster Care leave


• Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)


• Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation)

*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.

Qualifications

• Completion of undergraduate core coursework in accounting to include coursework in auditing 2 yrs. exp. in external auditing.


• -Or completion of undergraduate core coursework in public or business administration, economics, computer science or related field 16 semester or 24 quarter hours in accounting 2 yrs. exp. in external auditing.


• -Or 12 mos. exp. as Provider Reimbursement Analyst 1, 66191 with experience commensurate with type of audits to be conducted.


• -Or equivalent of Minimum Class Qualifications For Employment noted above.

Note: Positions which involve travel to audit sites in field also require valid Ohio Driver's License in order to operate state-owned vehicle or must be able to provide own transportation.

Job Skills: Accounting and Finance

ADA Statement

Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.

Drug-Free Workplace

The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.