Senior Reimbursement Analyst (Remote - US)

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Job Description Template

Date:

November 13, 2020

Job Title:

Senior Reimbursement Analyst

Reports to title:

System Director of Regulatory Reporting or Director of Reimbursement

# Direct reports:

0

Summary of Primary Function/General Purpose of Position (2-3 sentences)

This position is responsible for providing critical analytical, review and reimbursement support for reimbursement functions including Medicare, Medicaid, or other third-party cost reports, related audits, appeals, disproportionate share hospital (DSH) logs, drug discount program (340B) support, and CPT/HCPCS codes changes for assigned 4-6 entities. The senior analyst completes the monthly and year end entries for third-party reserves and summarizes data on reimbursement functions for market and local finance leadership.

Essential Job Functions

Essential Functions (7-10) Statements - List the essential functions of the job. Essential functions are the reasons a job exists.

Independently, prepares workpapers, reviews and submits annual Medicare and Medicaid cost reports and various other regulatory filings that may be required on behalf of System.

Independently, coordinates Medicare and Medicaid cost report reviews and audits. Audits and reviews include overall cost report, wage index, bad debt, S-10, Medicaid logs and Medicaid eligible days.

Prepares and reviews monthly settlement reserve entries.

Researches reimbursement and regulatory issues and provides analyses to System Director or other stakeholders.

Produces reports, analyzes, and integrates data and completes other projects accurately and efficiently

Develops and prepares reimbursement related reports or analyses as needed to serve reimbursement leadership.

Assists in the education of Reimbursement Analysts.

Supports the preparation and review of various logs used for the Medicare and Medicaid cost reports.

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This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Patient Population

The following must be included in all position descriptions that involve direct or indirect patient care.  This is a Joint Commission requirement.  Also, select the age of the patient population served:

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Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.  

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Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.

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Neonates (0-4 weeks)

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Adolescents (13-17 years)

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Infant (1-12 months)

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Adults (18-64 years).

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Pediatrics (1-12 years)

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Geriatrics (65 years and older)

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Not applicable to this position.

Employment Qualifications

Education Qualifications - List the minimum education, training, and experience required to perform the essential functions of the position. 

Required Minimum Education:

4 year/ Bachelors Degree

Specialty/Major:

Accounting, Business, or Finance

Preferred Education:

Graduate Degree (Masters)

Specialty/Major:

Accounting, Business, or Finance

Licensing/ Certification - If registration, certification or licensure is required, include the name of the accrediting or licensing body.

Licensure/Certification Required:

None

Licensure/Certification Preferred:

CPA, FHFMA, CNRA, or CRCR

Minimum Qualifications

Minimum Years and Type of Experience:

Minimum 3 years in healthcare consulting, governmental intermediary, or multi-hospital health system regarding Medicare and Medicaid reimbursement and cost report preparation.

Other Knowledge, Skills and Abilities Required:

Other Knowledge, Skills and Abilities Preferred:

Ability to research reimbursement topics and provide practical interpretations and solutions.  Strong organizational skills and uses critical thinking to query appropriate data for projects.  Experience with Ohio, Kentucky, Virginia, and/or South Carolina Medicaid reimbursement, Medicare medical education reimbursement, Medicare wage index and/or Medicare critical access hospital reimbursement preferred.

Bon Secours Mercy Healthis an equal opportunity employer.

We’ll also reward your hard work with:

• Comprehensive, affordable medical, dental and vision plans
• Prescription drug coverage
• Flexible spending accounts
• Life insurance w/AD&D
• An employer-matched 403(b) for those who qualify
• Paid time off
• Educational Assistance
• And much more

Scheduled Weekly Hours:

Work Shift:

Department:

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com.