Senior Reimbursement Analyst

010 OhioHealth Corporation; United States; Hybrid; USD 90,000 - 130,000; Full time

Job summary

OhioHealth Corporation in the United States seeks a Senior Reimbursement Analyst to manage Medicare and Medicaid cost reporting for our network of entities. You will supervise the Reimbursement Analyst team and ensure accurate regulatory filings and timely responses to audits.

Ideal candidates have 2–4 years of Medicare/Medicaid cost reporting experience, a Finance degree, and professional credentials such as CPA, MHA or MBA.

Qualifications

• Bachelor's degree in Finance required.
• CPA, MHA or MBA preferred.
• 2–4 years' experience in Medicare/Medicaid cost reporting as a Reimbursement Analyst or similar role.

Responsibilities

• Prepare, review and file Medicare and Medicaid cost reports for all OhioHealth entities.
• Subject matter expert on CMS cost reporting, DSH, Uncompensated Care, Bad debts, IME/GME, wage index, S-10, Ohio Medicaid, HCAP, UPL and Franchise Fee programs.
• Provide updates to Director of Revenue and Reimbursement and Manager of Reimbursement; support audits and engagements with external vendors.
• Supervise Reimbursement Analyst daily workflow, mentor staff, and prioritize tasks in a matrix environment.

Education

Bachelor's Degree: Finance

CPA, MHA or MBA

Job description

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities.

Job Description Summary

• This position will prepare, review and file the Medicare and Medicaid cost reports for all OhioHealth entities.
• This position will be responsible for ensuring the appropriate governmental Medicare and Medicaid reimbursement that is received for all of OhioHealth’s entities.
• This position is primarily responsible for the proactive calculations and modeling of new regulatory changes and impacts as well as variance analysis of third-party liability accounts. Provides supporting work papers and documentation for third-party inquires.
• This position has supervisory oversight of the Reimbursement Analyst daily work schedule including flow of information, teaching of reimbursement fundamentals and principals, review of work and setting daily priorities.
• This positon supports and works with the Sr. Reimbursement Consultant, Reimbursement Advisor and Manager of Reimbursement as needed on projects and processes.
• The Senior Reimbursement Analyst will learn to become a subject matter expert over time from exposure in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical Education, and Governmental Logs, (HCAP, UPL and Franchise Fee programs in the state of Ohio) as well as special projects as assigned.
• Extensive ongoing engagement of learning of Medicare and Medicaid cost reporting and reimbursement regulatory requirements, both federal and state is required.
• The Senior Reimbursement Analyst is required to use extensive interpersonal skills in communicating with all reimbursement department levels as well as outside departmental contacts at OhioHealth.
• This role functions in a heavily matrixed environment and requires strong prioritization, communication and planning skills.
• This position has a matrix reporting structure and reports directly the Manager of Reimbursement as well as the, Sr. Reimbursement Consultant, Reimbursement Advisor and Director of Revenue Reimbursement.

Responsibilities And Duties

This position will prepare, review and file the Medicare and Medicaid cost reports for all OhioHealth entities.

• Subject matter learning and expert on CMS cost reporting, disproportionate share (DSH), Uncompensated Care, Bad debt reporting, IME/GME, Medicare Wage Index, S-10 reporting, Tricare and 855’s, Ohio Medicaid, HCAP, UPL and Franchise Fee programs.
• Knowledge of Acute Care Hospitals, Critical Access Hospitals, Sole Community Hospitals and Rural Health Clinics.
• Knowledge of reimbursement in specialty areas such psych, inpatient rehabilitation units, Home Health and Hospice.
• Projects as assigned by Director of Revenue and Reimbursement and Manager of Reimbursement. Provide Director of Revenue and Reimbursement and Manager with updates. CGS audits and auditors Working with our legal vendor for Medicare Appeals. Working with OHA and CBSA facilities on wage index opportunities Special projects / analysis as assigned by the Director of Revenue and Reimbursement and Manager of Reimbursement

Minimum Qualifications

• Bachelor's Degree: Finance (Required)
• Additional Job Description: CPA, MHA or MBA.
• Experience with Medicare/Medicaid cost reporting 2-4 years as a Reimbursement Analyst or similar position(s).

Work Shift: Day

Scheduled Weekly Hours : 40

Department Reimbursement

Equal Employment Opportunity

Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations.

OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law.

WE Are Inspired to Do Our Best. OhioHealth is a nationally recognized, innovative healthcare system delivering world-class patient care in a supportive, professional environment filled with limitless opportunities to learn and grow. We are a unique organization in the healthcare field. Our model system of facilities encompasses a wide scope of expertise and care. For professionals, we are a place where people committed to doing their best are given the tools and resources to accomplish our mission every single day.

OhioHealth is recognized as a Great Place to Work CertifiedTM organization. The Great Place to Work® is a global authority on high-trust, high-performance workplace cultures. This recognition is one measure of our success in achieving a part of our vision to be an organization "where people want to work."