Senior Analyst - Reimbursement and Revenue Integrity - FT - Days - MHS

Memorial Healthcare System; Florida; On-site; USD 70,000 - 90,000; Full time

Job summary

Memorial Healthcare System in Hollywood, Florida, is seeking a Senior Reimbursement Analyst responsible for the preparation and analysis of Medicare and Medicaid reports. This role entails ensuring accuracy and compliance of regulatory submissions, analyzing impacts of legal changes, and supporting audits.

The ideal candidate will have a Bachelor's degree, strong critical thinking and communication skills, as well as over five years of relevant experience in healthcare reimbursement operations.

This role fosters collaborative initiatives linking all MHS departments to optimize reimbursement opportunities.

Qualifications

• Minimum of five years of experience overseeing reimbursement operations.
• Strong command of Medicare, Medicaid and Champus rules and regulations.
• Proficient in Microsoft Office and Cost Reporting Software.

Responsibilities

• Prepare schedules supporting reimbursement activities.
• Compile data for the annual Medicare and Medicaid cost reports.
• Participate in the monthly close process and annual auditing.

Skills

Critical thinking

Effective communication

Regulatory compliance

Analytical skills

Customer service

Education

Bachelor's degree in Accounting, Finance, Business Administration

Tools

Microsoft Office

Cost Reporting Software

Epic

Workday

Job description

Location

Hollywood, Florida

Summary

The Senior Reimbursement Analyst plays a key role in supporting the financial sustainability and regulatory compliance of Memorial Healthcare System through expert preparation and analysis of Medicare and Medicaid cost reports, and other governmental filings. This position is responsible for ensuring the accuracy and timeliness of complex regulatory submissions, analyzing the financial impact of state and federal regulatory changes, and supporting audits and strategic reimbursement initiatives.

Responsibilities

Extracts required data from MHS systems and prepares schedules supporting reimbursement activities. Participate in the monthly close and annual financial statement preparation related to net revenue and supports annual accounting audit of same. Function as primary backup to the Directors in the monthly close process. Compile data for Medicaid DSH and Low Income Pool (LIP) supporting schedules. Other duties, as assigned. Obtaining supporting materials from other MHS departments and external sources. Maintains registration for access to all state and federal databases. Participate in the preparation of the annual Medicare, Medicaid and Champus cost reports. Compile data and supporting schedules for the cost reports. Monitor and maintain various cost report statistics such as time studies, meal count and square footage. Provide key information to other MHS departments to enable business support systems to operate properly. Support department leadership with both external and internal reporting needs. Maintains roll forward schedule of third‑party settlement balances and their application as part of the monthly close process and annual financial audit.

Competencies

• ACCOUNTABILITY
• ACCOUNTING - COST REPORTS
• ACCURACY
• ANALYSIS OF FINANCIALS
• CUSTOMER SERVICE
• HEALTHCARE REGULATORY ENVIRONMENT
• MANAGING WORKLOADS
• REGULATORY COMPLIANCE
• RESPONDING TO CHANGE
• STANDARDS OF BEHAVIOR

Education And Certification Requirements

Bachelors (Required)

Additional Job Information

Complexity of Work: Requires critical thinking skills, effective communication skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate timely action. Essential to have thorough knowledge of Medicare, Medicaid and Champus rules and regulations and third party audit techniques. Strong command of regulatory reporting requirements. Proficient in Microsoft Office products and Cost Reporting Software. Exceptional analytical skills. Ability to collaborate across departments to drive operational excellence and maximize reimbursement opportunities. Knowledge of Hospital systems (Epic, Workday) preferred. Experience with Florida Medicaid and supplemental programs is highly desirable. Required Work Experience: Minimum of five (5) years of progressively responsible experience overseeing reimbursement operations, audit, or consulting projects related to reimbursement. Other Information: Additional Education Info: Bachelor's degree in Accounting, Finance, Business Administration, or related field required.

Working Conditions And Physical Requirements

• Bending and Stooping = 40%
• Climbing = 0%
• Keyboard Entry = 80%
• Kneeling = 0%
• Lifting/Carrying Patients 35 Pounds or Greater = 0%
• Lifting or Carrying 0 - 25 lbs Non-Patient = 40%
• Lifting or Carrying 25 - 75 lbs Non-Patient = 20%
• Lifting or Carrying > 75 lbs Non-Patient = 0%
• Pushing or Pulling 0 - 25 lbs Non-Patient = 40%
• Pushing or Pulling 26 - 75 lbs Non-Patient = 20%
• Pushing or Pulling > 75 lbs Non-Patient = 20%
• Reaching = 20%
• Repetitive Movement Foot/Leg = 0%
• Repetitive Movement Hand/Arm = 0%
• Running = 0%
• Sitting = 60%
• Squatting = 0%
• Standing = 60%
• Walking = 60%
• Audible Speech = 60%
• Hearing Acuity = 60%
• Smelling Acuity = 0%
• Taste Discrimination = 0%
• Depth Perception = 60%
• Distinguish Color = 60%
• Seeing - Far = 60%
• Seeing - Near = 60%
• Bio hazardous Waste = 0%
• Biological Hazards - Respiratory = 0%
• Biological Hazards - Skin or Ingestion = 0%
• Blood and/or Bodily Fluids = 0%
• Communicable Diseases and/or Pathogens = 0%
• Asbestos = 0%
• Cytotoxic Chemicals = 0%
• Dust = 0%
• Gas/Vapors/Fumes = 0%
• Hazardous Chemicals = 0%
• Hazardous Medication = 0%
• Latex = 0%
• Computer Monitor = 80%
• Domestic Animals = 0%
• Extreme Heat/Cold = 0%
• Fire Risk = 0%
• Hazardous Noise = 0%
• Heating Devices = 0%
• Hypoxia = 0%
• Laser/High Intensity Lights = 0%
• Magnetic Fields = 0%
• Moving Mechanical Parts = 0%
• Needles/Sharp Objects = 0%
• Potential Electric Shock = 0%
• Potential for Physical Assault = 0%
• Radiation = 0%
• Sudden Decompression During Flights = 0%
• Unprotected Heights = 0%
• Wet or Slippery Surfaces = 0%

Shift

Primarily for office workers - not eligible for shift differential

Disclaimer

This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.

Equal Opportunity Employer

Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.

Veteran's Preference

We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.

Employment Conditions

Employment is subject to post offer, pre-placement assessment, including drug testing.