Senior Reimbursement Analyst

LCMC Health; New Orleans (LA); On-site; USD 90,000 - 120,000; Full time

Job summary

LCMC Health is seeking a Senior Reimbursement Analyst who will compile information for claims submissions, serve as a central resource for reimbursement analyses, and assist with annual cost report preparation and other reporting requirements.

The role analyzes financial data, designs and generates reports for management to guide decisions on new and existing programs, stays current on Medicare/Medicaid regulations, and provides guidance to junior team members as needed.

Qualifications

• PC skills including Excel, Access, Word and PowerPoint are required.
• Knowledge of Medicare/Medicaid reimbursement principles and related regulations.
• Experience with cost reporting and reimbursement analyses for healthcare providers.

Responsibilities

• Assists in preparing accurate government regulatory reports, including Medicare/Medicaid cost reports.
• Compiles data and analyzes reimbursement patterns for various departments.
• Assists in developing cost reports and reports for audits and appeals.
• Researches regulatory changes and their impact on reimbursement, especially GME.
• Prepares and presents reimbursement studies for senior management.

Skills

Excel

Access

Word

PowerPoint

Medicare/Medicaid reimbursementPrincip

EDP familiarity

Education

BA in Business Administration or Accounting

Tools

CMS PRM regulations manuals

CMS 2552 software

CMS IACS/EIDM system

Medicare IRIS reporting system

electronic cost reporting software

Job description

Your job is more than a job

The Reimbursement Analyst Senior is responsible for compiling the information needed for claims submissions. Serves as a central resource for reimbursement analyses, audit and assists with the annual cost report preparation and other reporting requirements. Assists in building financial processes/models to estimate Medicare GME and other reimbursements based on current regulations and specific client circumstances. Provides and interprets reimbursement patterns and trend analyses for various departments. Provides guidance and support to junior team members as needed.

General Duties

Assists in the preparation of accurate government regulatory reports, including year‑end and interim Medicare/Medicaid cost reports for submission to the intermediary, within a designated timeframe.

• Assists in preparation of Medicare, Medicaid and CHAMPUS annual cost reports.
• Computes interim Medicare/Medicaid settlements and impact on reimbursement for the hospital.
• Provides support and documentation needed by various auditors such as independent, Medicare and Medicaid.
• Assists in providing all data and/or special reports and projects for Medicare/Medicaid appeals and/or reopening.
• Stays up to date on changes to Medicare reimbursement in general and specifically federal regulations related to graduate medical education (GME) and provides education about their impact to other team members and clients.

Analyzes financial data. Designs and generates reports for management's use in operational decisions regarding new and existing programs.

• Directs the preparation of reimbursement studies as needed by senior management.
• Researches regulations related to the implementation of new programs, services, and ventures, and develops techniques for maximizing reimbursement.
• Develops techniques for effective analysis of billing and collections efforts.

Develops, prepares & presents financial impact of all new & proposed Medicare / Medicaid regulations to senior management.

• Evaluates interim payments from the third‑party payers for accuracy & adequate cash flow.
• Coordinates with appropriate teams for the production of reports for cost reporting/cost analyses purposes.
• Reviews generally accepted accounting principles & auditing standards as they apply to the reimbursement area.

Assists in the development of contractual allowances for budget projections.

• Assists in the development of contractual allowances for budget projections.

Experience Qualifications

8 years government healthcare reimbursement and accounting experience in a healthcare setting.

Experience And Analytical Skills Related To Case Mix/Reimbursement Systems

• Experience and knowledge with CMS PRM regulations manuals, the CMS 2552 software system and the CMS IACS/EIDM system.
• Experience with Medicare IRIS reporting system.
• Experience with electronic cost reporting software systems.

Education Qualifications

BA in Business Administration or Accounting.

Skills And Abilities

PC skills (Excel, Access, Word, PowerPoint). Familiarity with EDP and microcomputer systems. Comprehensive knowledge of Medicare and Medicaid reimbursement principles relating to Home Office, Hospitals, Nursing Homes, and Home Health agencies.

Reporting Relationships

Does this position formally supervise employees? No.

Work Shift

Days (United States of America).

LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.

The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.