WVU Medicine
Senior Reimbursement Analyst - Net Revenue
WVU Medicine, Indian Trail, North Carolina, United States, 28079
Overview
Senior Reimbursement Analyst - Net Revenue role at WVU Medicine. This position is responsible for the reimbursement of all payers; tasks include filing compliant cost reports, acting as primary contact on assigned audits, and participating in the month end close process. Advance Excel skills are required. The individual must handle multiple tasks and see each to completion with minimal supervision and may assist with training of new analysts. Effective communication is important as this role interacts with various departments. Minimum Qualifications
Education, Certification, and/or Licensure:
Bachelor’s Degree in business administration, accounting, or finance. Experience:
Five (5) years’ of experience in finance or accounting. Preferred Qualifications
Education, Certification, and/or Licensure:
Advanced degree or Certification in accounting, finance, or healthcare administration. Experience:
Experience working in a health care or health system environment; experience working with CMS and/or Medicare auditors; experience with EPIC, Workday, Lawson, Strata Jazz and TOYON Absolute software; advanced computer and spreadsheet skills, primarily in Excel. Core Duties and Responsibilities
Prepare the annual cost reports for Medicare, Medicaid and TRICARE in accordance with government regulations. Analyze reports for increased reimbursement with an understanding of CCR and their impact on reimbursement. Primary contact on assigned hospital audits, work diligently to minimize reimbursement impact to hospital. Assess monthly cost estimates for necessary changes or material variances relating to hospital operations throughout the year. (CAH only) Prepare annual Reimbursement Budget models on assigned hospitals with accuracy using final regulations and Strata revenue and statistical reports; serve as a resource to the Reimbursement team. Coordinate the completion and preparation of the annual Uniform Report (UFR) for the WV Healthcare Authority; serves as a resource to the Reimbursement team. Understanding of Method II reimbursement and the impact on payments and deductions. (CAH only) Understand IME/GME, DSH, RHC, bad debts and other medical education programs. Look for opportunities to automate and improve current processes with a goal of increasing accuracy and efficiency. Analyze monthly contractual reserve estimates and communicate material changes to management; prepare journal entries. Assist with training of new analysts on department procedures and systems. Prepare Medicaid DSH survey and template for DSH Audits; review DSH audit adjustments for accuracy. Primary contact on Wage Index and Occupational Mix audits; review proposed adjustments from auditors and PUF files for accuracy. (Acute only) Update third party reserves and review monthly supplemental and pass through schedules for accuracy; prepare necessary journal entries. Verify and analyze interim rate calculations and final settlements by third party payer for accuracy; distribute updated rates to internal departments. Promote and contribute positively to the department by assisting with team members’ questions, contributing ideas and problem solving. Takes a leadership role in performance improvement through planning and implementing change; maintaining and improving productivity through attendance; and participation in staff meetings, committee meetings and cross functional group projects. Physical Requirements
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Frequent walking, standing, stooping, kneeling, reaching, pushing, lifting, grasping and feeling are necessary body movements. 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 comprehension ability. Working Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Office type environment. Ability to work remotely. Skills and Abilities
Cost reporting experience, financial analysis and interpretation of federal and state regulations. Strong communication skills to interact effectively with management, staff and external auditors. Excellent computer knowledge with advanced Excel skills.
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Senior Reimbursement Analyst - Net Revenue role at WVU Medicine. This position is responsible for the reimbursement of all payers; tasks include filing compliant cost reports, acting as primary contact on assigned audits, and participating in the month end close process. Advance Excel skills are required. The individual must handle multiple tasks and see each to completion with minimal supervision and may assist with training of new analysts. Effective communication is important as this role interacts with various departments. Minimum Qualifications
Education, Certification, and/or Licensure:
Bachelor’s Degree in business administration, accounting, or finance. Experience:
Five (5) years’ of experience in finance or accounting. Preferred Qualifications
Education, Certification, and/or Licensure:
Advanced degree or Certification in accounting, finance, or healthcare administration. Experience:
Experience working in a health care or health system environment; experience working with CMS and/or Medicare auditors; experience with EPIC, Workday, Lawson, Strata Jazz and TOYON Absolute software; advanced computer and spreadsheet skills, primarily in Excel. Core Duties and Responsibilities
Prepare the annual cost reports for Medicare, Medicaid and TRICARE in accordance with government regulations. Analyze reports for increased reimbursement with an understanding of CCR and their impact on reimbursement. Primary contact on assigned hospital audits, work diligently to minimize reimbursement impact to hospital. Assess monthly cost estimates for necessary changes or material variances relating to hospital operations throughout the year. (CAH only) Prepare annual Reimbursement Budget models on assigned hospitals with accuracy using final regulations and Strata revenue and statistical reports; serve as a resource to the Reimbursement team. Coordinate the completion and preparation of the annual Uniform Report (UFR) for the WV Healthcare Authority; serves as a resource to the Reimbursement team. Understanding of Method II reimbursement and the impact on payments and deductions. (CAH only) Understand IME/GME, DSH, RHC, bad debts and other medical education programs. Look for opportunities to automate and improve current processes with a goal of increasing accuracy and efficiency. Analyze monthly contractual reserve estimates and communicate material changes to management; prepare journal entries. Assist with training of new analysts on department procedures and systems. Prepare Medicaid DSH survey and template for DSH Audits; review DSH audit adjustments for accuracy. Primary contact on Wage Index and Occupational Mix audits; review proposed adjustments from auditors and PUF files for accuracy. (Acute only) Update third party reserves and review monthly supplemental and pass through schedules for accuracy; prepare necessary journal entries. Verify and analyze interim rate calculations and final settlements by third party payer for accuracy; distribute updated rates to internal departments. Promote and contribute positively to the department by assisting with team members’ questions, contributing ideas and problem solving. Takes a leadership role in performance improvement through planning and implementing change; maintaining and improving productivity through attendance; and participation in staff meetings, committee meetings and cross functional group projects. Physical Requirements
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Frequent walking, standing, stooping, kneeling, reaching, pushing, lifting, grasping and feeling are necessary body movements. 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 comprehension ability. Working Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Office type environment. Ability to work remotely. Skills and Abilities
Cost reporting experience, financial analysis and interpretation of federal and state regulations. Strong communication skills to interact effectively with management, staff and external auditors. Excellent computer knowledge with advanced Excel skills.
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