Reimbursement Analyst

Advocate Health; Milwaukee (WI); On-site; USD 65,000 - 90,000; Full time

Job summary

Advocate Health in Milwaukee, WI seeks a Finance/Revenue Analyst to assist with system-wide revenue analysis, audits, and external cost reports. You will coordinate with reimbursement staff and external auditors to ensure accurate Medicare/Medicaid reporting and compliant financial statements.

The ideal candidate has a Bachelor's in Finance or related field, at least 3 years in reimbursement, strong Excel and PowerBI skills, and the ability to work independently in a complex environment.

Qualifications

• Bachelor's degree in Finance or related field required.
• Typically 3 years of reimbursement experience including Medicare/Medicaid cost reports.
• Strong knowledge of third party payers, regulations, and financial statements.

Responsibilities

• Assist with plans and prepares revenue analysis for system wide programs and monitors revenue budgets.
• Assist with external audits and cost reports for Medicare/Medicaid and coordination with auditors.
• Prepare budgeting for Gross and Net Patient Revenue and ensure regulatory compliance.
• Analyze accounts receivable valuation and assist in optimizing reimbursement.
• Coordinate system monthly closing for Medicare/Medicaid liabilities and patient receivables.

Skills

Medicare/Medicaid regulations

Revenue analysis

Data analysis

Excel

PowerPoint

Communication

Independent work

Education

Bachelor's Degree in Finance or related field

Tools

Excel

Power BI

Epic Reporting Workbench

Slicer/Dicer

Job description

Major Responsibilities:

• Assist with plans and prepares revenue analysis for system wide programs, projects and services, and monitors revenue budgets and benchmarking activities. Acts as support for all system intermediary data requests, audits and exit conferences.

• Assists in preparation and provides necessary information required for the completion of system wide external financial audits, and Medicare and Medicaid interim and year-end cost reports. Assists with coordination of the year-end system financial audit with external auditors and reimbursement staff. Develops and maintains appropriate relationships with the Fiscal Intermediary and external auditors.

• Prepares analysis and assists in making recommendations to ensure that that all regulatory reviews are completed accurately and on time.

• Participates in the development and preparation of the system wide budgeting for Gross and Net Patient Revenue to ensure accuracy, timeliness, and compliance with accounting standards.

• Analyzes and reviews the monthly accounts receivable valuation and provides recommendations to ensure optimal reimbursement. Understands and oversees the tools used for calculation.

• Develops and provides coordination for the system wide monthly closing process with respect to Medicare/Medicaid liabilities and the allowances on patient receivables.

• Monitors processes to ensure accurate payment for Medicare/Medicaid and monitors interim payments to determine accuracy, appropriateness and potential liability. Requests adjustments from United Government Services (UGS) and updates internal systems.

• Develops and applies an understanding of Medicare and Medicaid regulations pertaining to current and proposed reimbursement and works directly with Government Affairs and external consultants to provide needed expertise.

• Coordinates, with the Financial Planning department(s), the preparation of System budgets as they pertain to third party reimbursement. Provides support to Financial Planning in the development of retrospective financial review and pro forma development.

Licensure, Registration, and/or Certification Required:

• None Required.

Education Required:

• Bachelor's Degree in Finance or related field.

Experience Required:

• Typically requires 3 years of experience in in reimbursement that includes experiences in preparation of Medicare/Medicaid cost reports, regulations and the analysis, modeling and reporting of third party payers.

Knowledge, Skills & Abilities Required:

• Demonstrated expertise with Medicare and Medicaid regulations in a health care or federal intermediary setting.

• Knowledge and understanding of third party regulations and the interrelationship of financial statements to not only comply with regulations but to maximize and develop strategies to increase the organization's reimbursement rate with ongoing changes.

• Demonstrates strong initiative and produces high quality analytical results. Able to perform tasks independently.

• Strong accounting background with experience in preparing and/or reviewing health care financial statements which are required to perform accurate account analysis.

• Strong proficiency in the use of the Microsoft Office (Excel, PowerPoint, Word, Access), software systems, data management tools or similar products.

• Proficiency in data mining and analysis.

• Demonstrated ability to work and function in a complex environment. Excellent written and verbal communication skills and the ability to communicate revenue cycle issues to all levels of the organization.

• Demonstrated ability to take initiative, produce high quality results, and perform assigned activities in an independent manner. Self-motivated and capable of carrying a project through to successful completion.

Preferred

• Advanced Excel skills

• Accounting skills

• Healthcare experience

• PowerBI experience

• Analytic tools in Epic; Slicer/Dicer and/or Reporting Workbench

• Accounts receivable experience

• Ledger entry experience

Physical Requirements and Working Conditions:

• Must be able to sit the majority of the workday.

• Must be able to lift up to 10 lbs. occasionally.

• Operates all equipment necessary to perform the job.

• Exposed to normal office environment.

• This position requires travel, so will be exposed to weather and road conditions.

#LI-remote

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.