SR REIMBURSEMENT ANALYST / REMOTE / Medicare Medicaid Cost Reports
• *This is a 100% remote work-from-home position** TITLE: Sr. Reimbursement Analyst / Medicare Medicaid Cost Reports DEPT: Reimbursement SHIFT: Days-Remote ESSENTIAL DUTIES & FUNCTIONS: · 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. EDUCATION: Minimum Level of Education Required: Bachelor's Degree in Business Administration majoring in Accounting, Finance or related business field required. EXPERIENCE: Minimum Level of Experience 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. Preferred experience: Experience in Medicare medical education reimbursement (IME/DGME) and Medicare provider enrollment system (PECOS)