Reimbursement Analyst

Carolinas Medical Center; Oak Brook (IL); Hybride; USD 46 000 - 68 000; Plein temps

Résumé du poste

Carolinas Medical Center seeks a Reimbursement Analyst to support system-wide revenue analysis, audits, and year-end reporting. The role is full-time, primarily remote with optional onsite luncheons in Wisconsin and Illinois, typically Monday–Friday 8am–5pm CST.

Required are a Bachelor’s degree in Finance or related field and about 3 years of reimbursement experience, including Medicare/Medicaid cost reports and third-party payers analysis. Travel to luncheons may be needed.

Qualifications

• Demonstrated expertise with Medicare and Medicaid regulations in a health care or federal intermediary setting.
• Knowledge of third party regulations and the interrelationship of financial statements to regulatory compliance and reimbursement.
• Strong initiative with high-quality analytical results; ability to work independently.
• Solid accounting background with experience in health care financial statements and account analysis.
• Proficiency in Microsoft Office (Excel, PowerPoint, Word, Access) and data management tools.

Responsabilités

• Prepare revenue analyses for system-wide programs, projects and services and monitor revenue budgets.
• Assist with audits, Medicare/Medicaid reports, and external auditors coordination.
• Support year-end cost reports and regulatory reviews.
• Contribute to budgeting for gross and net patient revenue."
• Monitor AR valuation and reimbursement processes.
• Coordinate monthly closing for Medicare/Medicaid liabilities and allowances.

Connaissances

Medicare regulations

Medicaid regulations

Revenue analysis

Data mining

Excel proficiency

Independent worker

Formation

Bachelor's Degree in Finance or related field

Outils

Excel

PowerPoint

Word

Access

Data tools

Description du poste

Department:

10208 Enterprise Corporate - Reimbursement

Status:

Full time

Benefits Eligible:

Yes

Hou rs Per Week:

40

Schedule Details/Additional Information:

Fulltime, Dayshift Monday - Friday 8am - 5pm CST. This role will be remote with option of joining onsite for monthly Wisconsin and Illinois luncheon's or as needed.

Relocation and Visa:

No relocation and no sponsorship or transfer of visa for this position now or in the future.

Pay Range:

$33.05 - $49.60

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.

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.

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.

Our Commitment to You:

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