Senior Medicare Reimbursement Analyst

HealthPartners, Inc.; BLOOMINGTON (MN); Hybrid; USD 70,000 - 105,000; Full time

Job summary

HealthPartners in Bloomington, MN is hiring a Reimbursement Analyst III to support Medicare cost reporting, revenue analysis, and regulatory filings.

The role emphasizes preparing cost reports, auditing support, and modeling net revenue with focus on payor relationships and compliance with State and federal requirements.

Qualifications

• Advanced knowledge of hospital accounting and Medicare cost accounting fundamentals.
• Knowledge of accounting, statistics and general business principles and practices.
• Ability to maintain effective working relationships with others.
• Ability to communicate effectively both written and oral.
• Ability to handle confidential information with discretion.
• Ability to use a PC (Microsoft Office, Excel, PowerPoint) and cost report software.
• Ability to work independently with light supervision.
• Advanced knowledge of third party reimbursement payment mechanisms and settlement procedures.
• Knowledge of hospital payor relationships and accounting.

Responsibilities

• Evaluation of Net Patient Services Revenue and Accounts Receivable (10%).
• Medicare Cost Report Preparation and Audit Support (50%).
• Decision Support System Modeling and Analysis (10%).
• Other Regulatory Reporting (20%).
• Preparation of annual net patient services revenue budget and related revenues (10%).

Skills

Hospital accounting

Medicare cost accounting

Accounting principles

Statistics

Business practices

Confidentiality

MS Office/Cost reports

Independence

Reimbursement mechanisms

Payor relationships

Education

Bachelor’s degree in Accounting or Finance

Job description

HealthPartners is hiring a Reimbursement Analyst III.

The Reimbursement Analyst III is responsible for the preparation of hospital, hospice, home health agency, home office and skilled nursing facility cost reports, support for annual external audit related to net revenue valuation, net accounts receivable valuation, and pay or settlement liabilities. This position is also responsible for maintaining decision support system reimbursement modeling and auditing of same to ensure that calculated net revenues reasonably match actual payments. Other special analysis related to patient services, government regulatory issues and general accounting as assigned.

MINIMUM QUALIFICATIONS:

Education:	Bachelor’s degree in Accounting or Finance
Experience:	3- 5 years of experience in Medicare cost reporting or related healthcare finance area
Licensure/ Registration/ Certification:	None
Knowledge, Skills and Abilities:	Advanced knowledge of hospital accounting and Medicare cost accounting fundamentals Knowledge of accounting, statistics and general business principles and practices Ability to maintain effective working relationships with others Ability to communicate effectively both written and oral Ability to handle confidential information with discretion Ability to use a personal computer (Microsoft Office, Excel, PowerPoint) and cost report preparation software Ability to work independently with light supervision Advanced knowledge of third party reimbursement payment mechanisms and settlement procedures Knowledge of hospital payor relationships and accounting

MAJOR JOB DUTIES AND TASKS:	Percentage Of Time:
1.	Evaluation of Net Patient Services Revenue and Accounts Receivable	10%
Monthly analysis and valuation of net patient services revenue
Interim updating of Medicare and third party settlement liabilities
Quarterly evaluation of net patient accounts receivable and adjustments as required
External Audit resource for documentation needed to audit net patient revenue and net patient accounts receivable valuation
2.	Medicare Cost Report Preparation and Audit Support	50%
Prepare cost reports for Regions and HealthPartners affiliates
Assist the Reimbursement Manager with Medicare audit support as needed
Assist the Reimbursement Manager with the preparation of Medicare appeal Documentation and position paper preparation as needed
3.	Decision Support System Modeling and Analysis	10%
Modeling of Net Revenue Reimbursement for Medicare & Medicaid
Auditing of Decision Support System reimbursement and costing
Analysis of regulatory and program changes using decision support system
4.	Other Regulatory Reporting	20%
Filing of annual Department of Health Hospital Annual Report based on existing State of Minnesota regulations
Filing of annual Department of Health Medical Education and Research Cost grant application based on existing State of Minnesota regulations
Completion of trade association survey data related to patient services revenue and statistical data available from regular analytical records
5.	Preparation of annual net patient services revenue budget and associated other operating revenues	10%
Preparation of assumption driven inpatient and outpatient gross revenue, contractual allowance and net patient services revenue budget based on historical data and business volume changes as communicated by management direction
Prepare analysis for mid year forecasting of net revenue