Senior Reimbursement Analyst (Medicare/Medicaid)

Intermountain Healthcare Inc.; Pierre (SD); Remote; USD 47,000 - 74,000; Full time

Job summary

Intermountain Health is seeking a financial reimbursement analyst to independently prepare and review complex Medicare and Medicaid settlements, cost reports, and surveys for multiple facilities. The role supports the organization by interpreting regulations, performing data-driven analyses, and collaborating with Finance, Revenue Cycle, Operations, and leadership to optimize reimbursements.

Responsibilities include preparing settlements, reviewing audit adjustments, mentoring junior staff, and

Qualifications

• Demonstrated experience in a role requiring data analysis.
• Demonstrates computer skills including spreadsheets, databases, word processing, and Internet.
• Demonstrated experience with third-party financial accounting, contractual allowances, cost reports and surveys

Responsibilities

• Performs routine and non-routine tasks requiring more in-depth analysis and is expected to identify alternatives and recommend plans to resolve problems.
• Performs or reviews reimbursement processes (i.e., reconciliation of third-party G/L accounts, calculation of actual and budgeted contractual allowances and variances, monitoring of individual claims (logs), etc.). Interacts with HIM, PAS, and hospital finance staff as needed.
• Prepares monthly Medicare and Medicaid settlement and policy reserve calculations using technically acceptable and reasonably conservative reimbursement methodologies.
• Prepares or reviews cost reports and surveys, reviews audit adjustments and settlements, and files appeals and exception requests to appropriately maximize reimbursement. Interacts with Medicare Administrative Contractor, State Medicaid, and hospital personnel as needed.
• Acts as a mentor. As assigned, coordinates training, direction and review of those working with reimbursement functions.
• Manages scope and completion of work, meeting deadlines, and providing deliverables to the customers or end users. Manages complex projects, schedules and facilitates meetings as necessary to complete assignments. Develops, documents and revises system design procedures, test procedures and quality standards.
• Investigations changes in reimbursement and communicates potential impacts to reimbursement. Communicates effectively with site and system financial leadership to establish key financial variables requiring special analysis.

Skills

Reconciliation

Accounting

Accounts Payable/Receivable

Medicare

Medicaid

General Ledger

Financial Statements

Analytical Thinking

Reimbursement

Education

Bachelor’s degree in accounting, Finance or other business-related field

Job description

Intermountain Health is seeking a financial reimbursement analyst to independently prepare and review complex Medicare and Medicaid settlements, cost reports, and surveys for multiple facilities. The role supports the organization by interpreting regulations, performing data-driven analyses, and collaborating with Finance, Revenue Cycle, Operations, and leadership to optimize reimbursements.

Responsibilities include preparing settlements, reviewing audit adjustments, mentoring junior staff, and