Senior Reimbursement Analyst

Performs revenue management functions related to home office third party cost reports, third party appeals, third party payer contract negotiations, analysis of financial impact of changes in third party regulations, and various revenue improvement initiatives. Employment Type : Full time Shift : Day Shift Description : Performs revenue management functions related to home office third party cost reports, third party appeals, third party payer contract negotiations, analysis of financial impact of changes in third party regulations, and various revenue improvement initiatives. Essential Functions : Knows, understands, incorporates and demonstrates the mission, vision and values of Trinity Health in leadership behaviors, practices and decisions. Conducts prospective analysis of the potential financial impact on the member organizations of major changes in Medicare and Medicaid policies. Assists in related advocacy efforts regarding such regulatory changes. Monitors policies and procedures to ensure reimbursement practices adhere to federal, state and other third-party reimbursement regulations. Prepares Annual Medicare, Medicaid, Blue Cross and Tricare cost reporting for the Trinity Health Corporate Office and Trinity Information Systems. Prepares quarterly Medicaid reporting schedules. Prepares Rolling Forecasts and Annual Budgets. Participates in the Medicare, Medicaid and Blue Cross audits of Trinity Health Corporate Office, Trinity Information Systems, and the various insurance programs with focus on Graduate Medical Education, Disproportionate Share, Bad Debt and the S-10. Analyzes tentative and final settlements. Coordinates, researches and analyzes prior year reopening and appeals. Prepares financial month end close reporting for Net Revenue. Prepares analyses and interprets highly complex reimbursement issues. Prepares complex financial models and analyses to assure proper reimbursement. Participates in third-party payer preparing impact analysis and recommendations. Participates in developing and monitoring appeals with third party payers. Provides analytical reimbursement support, consulting, and education to the corporate office and member organizations. Reviews and analyzes member organization third party reserves and net revenue/contractual calculations. Conducts analysis related to revenue improvement initiatives. Prepares project analysis regarding operational issues, new programs, service lines, expansions, etc. Serves as a subject matter expert and resource by providing guidance and problem resolution to internal associates on matters impacting projects and day-to-day assignments. Minimum Qualifications : Bachelor’s degree in Business Administration, Finance, Accounting, Informatics or related field or an equivalent combination of education and related experience. Five (5) to seven (7) years of progressively responsible operational or consulting experience in revenue management. Some knowledge and experience of the healthcare industry or hospital financial operations. Advanced proficiency with Microsoft product suite (MS Word, Excel, Power Point), financial systems/software, relational database management and business intelligence reporting tools. Mucht possess a high degree of analytical, quantitative, evaluative and problem-solving skills. Our Commitment : Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

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