Children's Hospital & Medical Center - Omaha
Senior Net Revenue & Reimbursement Analyst
Children's Hospital & Medical Center - Omaha, Omaha, Nebraska, us, 68197
Overview
At Children’s Nebraska, our mission is to improve the life of every child through exceptional care, advocacy, research and education. As the state’s only full-service pediatric healthcare center, we provide comprehensive, holistic care to our patients and families—from primary and specialty care to behavioral health services and everything in between. Dedicated to a People First culture, we foster an environment with joy, belonging, wellbeing, learning and growth. Turn your passion into purpose and make a difference where it matters most.
A Brief Overview
Subject matter expert on net patient revenue, setting reserves on patient A/R, cost reporting, DSH reporting, and other agency reporting over net patient revenue and reimbursement. Oversees general ledger accounts and ensures accuracy of financial statements by maintaining records of assets, liabilities, profit and loss or other financial activities. Perform variance analysis and interpret results. Analyzes financial data in order to prepare reports, analysis and forecasts. Lead projects and provides training and guidance to other staff members.
Essential Functions Cost Reporting
Coordinates preparation of all Medicare and Medicaid cost reports.
Analyzes, interprets, and utilizes statistics maintained by the BI team for the cost reporting.
Agencies and Surveys
Manages and prepares all DSH and other federal and state surveys
Verifies data for DME/IME payments and works with DHHS as needed
Coordinates with Graduate Medical Education office to ensure compliance with Resident reporting
Continually monitor changes in regulations and payment methodologies
Conducts research on Federal and State regulations/laws
Coordinates regulatory reimbursement audits of the hospital and represents the System • Responds to proposed audit adjustment
Revenue Cycle Analytics System, Analysis & Net Revenue Accounting
Manages Kodiak Revenue Cycle Analytics (RCA) systems, including, but not limited to, RCA system maintenance, reconciliations between systems, monthly reserve processes, and reporting
Estimates net patient revenue and manages the accounts receivable reserve
Reviews and make necessary changes to EPIC mapping for new accounts, adjustment codes, payment codes, and other transactional mapping data. Ensures all systems are aligned
Records and reconciles gross revenue from patient financial accounting system to accounting systems
Prepares journal entries, account reconciliations, and account analysis to maintain and reconcile the general ledger account balances
Ensures that all expected reimbursement calculations are accurate
Prepares and analyzes reports and effectively communicates findings
Continuously seek efficiencies in processes, make and implement recommendations to improve accounting processes and procedures
Work on special projects as needed
Capable of constructively engaging with various management levels
Maintain working knowledge of GAAP • Ensures compliance with Generally Accepted Accounting Principles (GAAP), governmental regulations, contractual obligations, and internal policies
Assists in maintaining and updating internal controls over financial reporting
Performs and/or assists in technical accounting research and implementation
Work with Revenue Cycle to analyze billing corrections, evaluate payment changes, and assist with various analysis to understand impact to the organization
Work with Director of Managed Care to aid in understanding of reimbursement issues and analyze payor contract changes
Coordinate with various areas in analysis of new departments, impacts of business changes, budgets, and related effects
Assists with consolidated forecasts and budgets, and analyzes trends in revenue, contractual adjustments and other related areas
Education Qualifications
Bachelor's Degree from an accredited college or university in Accounting or Finance Required
Master's Degree of Accounting or MBA Preferred
Experience Qualifications
Minimum 4 years of experience in net patient revenue accounting and reimbursement functions Required
Experience with cost reporting Required
Experience working with financial systems Required
Skills and Abilities
Cost reporting and reimbursement accounting experience required
Ability to communicate complex concepts in simple form to non-finance users to understand the appropriate use and limits of information provided.
High level of systems analysis and problem solving skills necessary in order to develop and implement new procedures and solutions.
Ability to utilize critical thinking skills, do strategic planning and project management.
High sense of purpose and urgency and strong analytical skills.
Ability to work with tight deadlines and identify priorities in a fast-paced, highly visible environment while maintaining attention to detail.
Strong people and interpersonal skills; ability to build relationships; team player.
Fosters creativity, innovation and divergent thinking in self and others.
Ability to effectively implement change.
Demonstrated experience teaching, mentoring and developing skills sets, where appropriate.
Ability to take complex analytical data and synthesize it in reportable and understandable context.
Demonstrated experience teaching, mentoring and developing skills sets, where appropriate.
Strategic and forward-thinking
Flexible and creative
Articulate, collaborative and approachable
Strong written and oral communication skills are required.
GAAP knowledge required
Licenses and Certifications
CPA Preferred
Children’s is an equal opportunity employer, embracing and valuing the unique strengths and differences of people. We cultivate an inclusive environment of respect and trust where we all belong. We do not discriminate based on race, ethnicity, age, gender identity, religion, disability, veteran status, or any other protected characteristic.
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A Brief Overview
Subject matter expert on net patient revenue, setting reserves on patient A/R, cost reporting, DSH reporting, and other agency reporting over net patient revenue and reimbursement. Oversees general ledger accounts and ensures accuracy of financial statements by maintaining records of assets, liabilities, profit and loss or other financial activities. Perform variance analysis and interpret results. Analyzes financial data in order to prepare reports, analysis and forecasts. Lead projects and provides training and guidance to other staff members.
Essential Functions Cost Reporting
Coordinates preparation of all Medicare and Medicaid cost reports.
Analyzes, interprets, and utilizes statistics maintained by the BI team for the cost reporting.
Agencies and Surveys
Manages and prepares all DSH and other federal and state surveys
Verifies data for DME/IME payments and works with DHHS as needed
Coordinates with Graduate Medical Education office to ensure compliance with Resident reporting
Continually monitor changes in regulations and payment methodologies
Conducts research on Federal and State regulations/laws
Coordinates regulatory reimbursement audits of the hospital and represents the System • Responds to proposed audit adjustment
Revenue Cycle Analytics System, Analysis & Net Revenue Accounting
Manages Kodiak Revenue Cycle Analytics (RCA) systems, including, but not limited to, RCA system maintenance, reconciliations between systems, monthly reserve processes, and reporting
Estimates net patient revenue and manages the accounts receivable reserve
Reviews and make necessary changes to EPIC mapping for new accounts, adjustment codes, payment codes, and other transactional mapping data. Ensures all systems are aligned
Records and reconciles gross revenue from patient financial accounting system to accounting systems
Prepares journal entries, account reconciliations, and account analysis to maintain and reconcile the general ledger account balances
Ensures that all expected reimbursement calculations are accurate
Prepares and analyzes reports and effectively communicates findings
Continuously seek efficiencies in processes, make and implement recommendations to improve accounting processes and procedures
Work on special projects as needed
Capable of constructively engaging with various management levels
Maintain working knowledge of GAAP • Ensures compliance with Generally Accepted Accounting Principles (GAAP), governmental regulations, contractual obligations, and internal policies
Assists in maintaining and updating internal controls over financial reporting
Performs and/or assists in technical accounting research and implementation
Work with Revenue Cycle to analyze billing corrections, evaluate payment changes, and assist with various analysis to understand impact to the organization
Work with Director of Managed Care to aid in understanding of reimbursement issues and analyze payor contract changes
Coordinate with various areas in analysis of new departments, impacts of business changes, budgets, and related effects
Assists with consolidated forecasts and budgets, and analyzes trends in revenue, contractual adjustments and other related areas
Education Qualifications
Bachelor's Degree from an accredited college or university in Accounting or Finance Required
Master's Degree of Accounting or MBA Preferred
Experience Qualifications
Minimum 4 years of experience in net patient revenue accounting and reimbursement functions Required
Experience with cost reporting Required
Experience working with financial systems Required
Skills and Abilities
Cost reporting and reimbursement accounting experience required
Ability to communicate complex concepts in simple form to non-finance users to understand the appropriate use and limits of information provided.
High level of systems analysis and problem solving skills necessary in order to develop and implement new procedures and solutions.
Ability to utilize critical thinking skills, do strategic planning and project management.
High sense of purpose and urgency and strong analytical skills.
Ability to work with tight deadlines and identify priorities in a fast-paced, highly visible environment while maintaining attention to detail.
Strong people and interpersonal skills; ability to build relationships; team player.
Fosters creativity, innovation and divergent thinking in self and others.
Ability to effectively implement change.
Demonstrated experience teaching, mentoring and developing skills sets, where appropriate.
Ability to take complex analytical data and synthesize it in reportable and understandable context.
Demonstrated experience teaching, mentoring and developing skills sets, where appropriate.
Strategic and forward-thinking
Flexible and creative
Articulate, collaborative and approachable
Strong written and oral communication skills are required.
GAAP knowledge required
Licenses and Certifications
CPA Preferred
Children’s is an equal opportunity employer, embracing and valuing the unique strengths and differences of people. We cultivate an inclusive environment of respect and trust where we all belong. We do not discriminate based on race, ethnicity, age, gender identity, religion, disability, veteran status, or any other protected characteristic.
#J-18808-Ljbffr