Senior Reimbursement Analyst – Regulatory and Reporting

This is a fully remote position, open to applicants in Ohio, +2 more states.

📋 Description

• Create reports and analyze data from multiple sources to prepare and submit cost reports along with reimbursement filings.

• Offer precise support and keep management and relevant departments informed about evolving reimbursement regulations.

• Innovate technical and process enhancements, efficiencies, strategies, and modeling for the facility and systems.

• Execute, advise on, submit, and assist with third-party cost reports and associated filings and amendments.

• Aid in audits and reviews, including Wage Index, Occupational Mix, DSH, S-10, Bad Debt, Charity Care, NAHE, and DGME/IME.

• Organize data compilation from departmental systems and outside sources.

• Monitor and communicate filing deadlines, settlements, amendments, audits, adjustments, and reimbursement matters.

• Investigate and document work papers, schedules, forms, governing rules, legislation, and reimbursement effects.

• Examine data for accuracy, consistency, technical correctness, regulatory adherence, and audit criteria.

• Prepare reimbursement budget models and the annual Uniform Report for the WV Healthcare Authority.

• Assess rate structures and future impacts; collaborate with the internal Audit team.

• Cultivate database report-writing expertise in Strata and other systems.

• Complete, analyze, and submit Medicaid DSH Surveys and DSH audits.

• Collect supporting documentation for Wage Index, Occupational Mix, transplant, Nursing and Allied Health, Bad Debt, Charity Care, S-10, desk review, and IME/GME Overlap.

• Provide data and assistance to compute third-party receivables and payables.

• Offer analytical insights and substantiation during annual financial and governmental audits.

• Coordinate reimbursement projects with external consultants.

• Identify issues and implement measures to prevent losses, optimize reimbursement, and adhere to deadlines.

• Assist Finance and Reimbursement Department functions, performance improvement, quality assurance, and teamwork.

• Work independently, replicate prior-year work papers, and collaborate effectively to accomplish responsibilities.

⛳️ Requirements

• Bachelor’s Degree OR HFMA Certified Hospital Cost Report Specialist (CHCRS).

• A minimum of three (3) years of experience in successfully completing and submitting Medicare Cost reports for Critical Access and/or Acute/IPPS facilities.

• A minimum of three (3) years of experience with hospital electronic health record systems (EPIC, Cerner, etc.), Cost Reporting applications, general ledger/accounting systems, OR CMS/MAC cost reporting procedures, processes, completion, submission, supporting schedules, documentation requirements, regulations, strategies, and audits.

• At least two (2) years of experience with advanced computer and spreadsheet skills, primarily in Excel.

• Ability to read and write legibly in English.

• Extensive background in financial analysis and interpretation of federal and state regulations.

• Specialized knowledge in hospital healthcare reimbursement, including cost reporting, bad debt, S-10, Wage Index/Occupational Mix, DSH, 340b, and rate setting.

• Proficiency in Microsoft Office Suite (Excel, Access, Word, Outlook) and other essential computer skills.

• Capability to work effectively and independently in a fast-paced environment.

• Ability to meet deadlines with accuracy, intention, and efficiency.

🏝️ Benefits

• Option to work remotely.

• 40 scheduled hours per week.

• Educational opportunities provided by the hospital to enhance skill-related abilities.