Reimbursement Analyst

This is a fully remote position, open to applicants in Alabama, +32 more states.

📋 Description

• Conducts comprehensive system-wide analysis, modeling, reporting, and assessment of correct reimbursements from third-party payers, adhering to regulatory, accounting, and contractual guidelines.

• Works in collaboration with the Manager of Reimbursement to gather necessary information for the preparation of Medicare and Medicaid cost reports, as well as addressing related reimbursement matters during the monthly closing process, year-end audits, and annual budgeting.

• Aids in planning and preparing revenue analysis for system-wide programs, projects, and services, while also monitoring revenue budgets and benchmarking activities.

• Provides support for all system intermediary data requests, audits, and exit conferences.

• Assists in the preparation of and supplies essential information for the completion of system-wide external financial audits, working alongside teams on Medicare and Medicaid interim and year-end cost reports.

• Aids in the coordination of the year-end system financial audit with external auditors and reimbursement personnel.

• Cultivates and maintains appropriate relationships with the Fiscal Intermediary and external auditors.

• Compiles analysis and aids in formulating recommendations to guarantee that all regulatory reviews are conducted accurately and punctually.

• Engages in the development and preparation of the system-wide budgeting for Gross and Net Patient Revenue, ensuring accuracy, timeliness, and adherence to accounting standards.

• Reviews and analyzes the monthly accounts receivable valuation, providing recommendations to ensure optimal reimbursement.

• Understands and supervises the tools employed for calculations.

• Develops and coordinates the system-wide monthly closing process concerning Medicare/Medicaid liabilities and the allowances on patient receivables.

• Requests adjustments from United Government Services (UGS) and updates internal systems accordingly.

• Cultivates an understanding of Medicare and Medicaid regulations related to current and proposed reimbursements, collaborating directly with Government Affairs and external consultants to provide necessary expertise.

• Works with the Financial Planning department(s) to prepare System budgets related to third-party reimbursements.

• Supports Financial Planning in developing retrospective financial reviews and pro forma analyses.

⛳️ Requirements

• Bachelor's Degree in Finance or a related field.

• Generally requires 3 years of experience in reimbursement, including the preparation of Medicare/Medicaid cost reports, regulations, and the analysis, modeling, and reporting of third-party payers.

• Proven expertise in Medicare and Medicaid regulations within a healthcare or federal intermediary context.

• In-depth knowledge of third-party regulations and the relationship between financial statements, not only to ensure compliance but also to enhance and formulate strategies for increasing the organization's reimbursement rate amidst ongoing changes.

• Strong accounting foundation with experience in preparing and/or reviewing healthcare financial statements essential for conducting accurate account analysis.

• High proficiency in Microsoft Office (Excel, PowerPoint, Word, Access), software systems, data management tools, or similar applications.

• Competence in data mining and analysis.

🏝️ Benefits

• Paid Time Off programs.

• Health and welfare benefits including medical, dental, vision, life insurance, and Short- and Long-Term Disability.

• Flexible Spending Accounts for eligible healthcare and dependent care expenses.

• Family benefits such as adoption assistance and paid parental leave.

• Defined contribution retirement plans with employer match and additional financial wellness programs.

• Educational Assistance Program.