[Remote] SR REIMBURSEMENT ANALYST / REMOTE / Medicare Medicaid Cost Reports

Note: The job is a remote job and is open to candidates in USA. Premier Health Partners is seeking a Sr. Reimbursement Analyst to handle Medicare and Medicaid cost reports. The role involves collecting and analyzing data, preparing various cost reports, and ensuring compliance with federal and state regulations.

Responsibilities

• Collects, analyzes all underlying data and prepares supporting documentation for:
• The Medicare cost report Worksheet S-10. Reviews outside consultant logs and schedules. Reviews audit adjustments for accuracy
• The Medicare cost report Medicaid DSH eligibility. Prepares additional provider research files and reviews outside consultant logs
• The Medicare cost reports Traditional Medicare Bad Debt and Dual Eligible logs
• The Medicare cost report Wage Index. Reviews audit adjustments for accuracy
• Prepares the calculation of accounts receivable and third-party reserves including the timely submission of the monthly journal entry along with additional analyses as needed
• Collects and analyzes all underlying data and prepares the Medicaid pending conversion calculations
• Prepares 340 B trial balances for inclusion with the annual HRSA submissions
• Prepares Medicare gain/loss analysis for Schedule H of Form 990
• Assists in the annual net revenue budget and three-year forecasting process. Research and completion of all governmental modeling is the primary focus
• Assists with the preparation of E&Y audit workpapers
• Reviews CMS/MAC rate reviews and audit adjustments for accuracy
• Prepares amended Medicare and Medicaid cost reports and Tricare capital and direct medical education reports and supporting schedules as needed
• Reviews tentative cost report settlements and final cost report settlements including audit adjustments for accuracy
• Prepares Medicare and Medicaid reimbursement factors and reimbursement calculators for Inpatient, Outpatient, Psych, and Rehab
• Collects and analyzes all underlying data in conjunction with the Rehab Unit and prepares the submission for the Inpatient Rehab Unit 75% compliance report for exemption from the Inpatient Prospective Payment System
• Collects and analyzes all underlying data, prepares all supporting documentation, and submits in a timely and accurate manner the Medicare occupational mix surveys. Reviews audit adjustments for accuracy
• Prepares HCAP logs and obtains supporting documentation for independent consultant review. Also, prepares the matching data in the formats used for the Medicaid cost report
• Prepares Myers & Stauffer logs for the federal DSH audits that match the Medicaid cost report in the required format in a timely and accurate manner
• Submits documentation for the Kentucky Workers’ Compensation Hospital Fee Schedule cost-to-charge ratio calculation
• Collects all underlying data, prepares detail and summary invoices, and payment reconciliations for the Montgomery County Indigent Ill Levy submissions
• Acts as a liaison between Reimbursement and the report writing team to assist in regulatory data revisions
• Prepares detailed analysis of regulatory changes to determine the reimbursement impact to PHP
• Ensures compliance with Federal and State laws when using PHP provider numbers, including Provider Based Status rules
• Maintains current working knowledge of Medicare, Medicaid, and other regulations. Assists in providing education with Federal rules and regulations

Skills

• Bachelor's Degree in Business Administration majoring in Accounting, Finance or related business field required
• 3-5 years of job-related experience required
• Hospital reimbursement required, including Medicare and Medicaid cost report experience required
• Current working knowledge of the financial statement process, running ad-hoc patient financial system and/or general ledger financial reports, and strong financial skills required
• Experience in Medicare medical education reimbursement (IME/DGME) and Medicare provider enrollment system (PECOS)

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