[Hiring] Senior Reimbursement Analyst @WVU Medicine

Role Description

The primary focus of this position is to design reports and analyze data from various sources in order to prepare and submit cost reports and other reimbursement filings as required by regulatory agencies, state and federal governments, contractors, etc.

• Extensive knowledge of third-party reimbursement regulations is required to provide accurate support and inform management of the impact of changing reimbursement regulations.
• Provides extensive analysis and develops facility and system technical and process improvements, efficiencies, strategies, and modeling to enhance reimbursement, meet compliance standards, reduce audit risk, and provide accurate data, forecasts, budgets, reports, ROI, etc.
• Excellent communication skills are imperative to coordinate information from various levels of the organization, with Medicare and Medicaid auditors, external vendors, etc.
• Must be able to use critical thinking and analysis skills to address issues, questions, complete projects, and meet deadlines without direct management involvement.
• Must operate independently in a highly efficient and effective manner and support the implementation of any new or updated process.

Qualifications

• Bachelor’s Degree OR HFMA Certified Hospital Cost Report Specialist (CHCRS)
• Three (3) years of experience in successful completion and submission of Medicare Cost reports for Critical Access and/or Acute/IPPS facilities.
• 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 procedure, process, completion, submission, supporting schedules and documentation requirements, regulation, strategy, and audit.
• Two (2) years of experience with advanced computer and spreadsheet skills, primarily in Excel.

Requirements

• Three (3) years of experience in healthcare accounting (general ledger, trial balance, income statement, balance sheet, cash flow, etc.), finance, revenue cycle, data analysis, and/or reimbursement.
• Successful navigation of at least two (2+) years of corresponding reviews, surveys, and audits (Interim rate reviews, S-10, Bad Debt, Charity Care, DSH, Wage Index, Occupational Mix, desk review, etc.)

Core Duties and Responsibilities

• Completes, advises on, submits, and provides support related to any third-party cost reports (Medicare, WV Medicaid, PA Medicaid, Ohio Medicaid, Champus/Tricare, etc.) or other filings.
• Coordinates compiling of all data required for completion of any necessary filing from various departments systems and external sources.
• Conducts research and provides documentation and explanations for all necessary workpapers, schedules, and forms.
• Analyzes data from all sources to ensure accuracy, consistency, and technical correctness.
• Assists with and prepares reimbursement budget models with accuracy using the most current regulations.
• Analyzes current rate structure and develops current and future impact based on applicable reimbursement factors.
• Maintains and continually improves on technical skills needed to manipulate and analyze data.
• Utilizes and develops database report writing skills in Strata and other systems as needed.
• Completes, analyzes, and submits Medicaid DSH Survey and DSH audit annually.
• Compiles supporting documentation for various audits and develops technical and reporting efficiencies.
• Provides necessary data and support to the reimbursement team to calculate third-party receivables and payables.
• Coordinates reimbursement projects with various consultants as dictated by project needs.
• Participates in meeting the objectives of the work unit and goals of the department.
• Promotes and contributes positively to the teamwork of the department.
• Identifies and addresses problems, questions, concerns, analysis, etc. in a timely manner.
• Provides any other support to the Finance and Reimbursement Department as needed.
• Must operate independently in a highly efficient and effective manner.
• Effectively communicate and collaborate in a team atmosphere to fulfill responsibilities.
• Supports performance improvement and quality assurance initiatives.
• Participates in educational opportunities as provided by the hospital.

Physical Requirements

• Frequent walking, standing, stooping, kneeling, reaching, pushing, lifting, grasping, and feeling are necessary body movements utilized in performing duties.
• Must be able to sit for extended periods of time.
• Must be able to read and write legibly in English.
• Visual acuity must be within normal range.
• Must have hearing abilities to communicate effectively via telephone and in person.
• Must have reading and comprehensive ability.

Working Environment

• Office type environment.
• Ability to work remotely.

Skills and Abilities

• Extensive experience in financial analysis and interpretation of federal and state regulations.
• Specialized knowledge of hospital healthcare reimbursement, including cost reporting, bad debt, S-10, Wage Index/Occupational Mix, DSH, 340b, and rate setting.
• Strong communication skills to interact effectively with management, staff, and external auditors.
• Excellent analytical, critical thinking, and problem-solving abilities.
• Effective organizational and time management skills with the ability to meet deadlines.
• Proficiency in Microsoft Office Suite (Excel, Access, Word, Outlook) and other fundamental computer skills.
• Ability to work effectively and independently managing tasks in a fast-paced environment.

Additional Job Description

• Scheduled Weekly Hours: 40
• Shift: Exempt
• United States of America (Exempt)
• Company: SYSTEM West Virginia University Health System
• Cost Center: 540 SYSTEM Finance and Reimbursement