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Reimbursement Analyst- Regulatory and Reporting

Reimbursement Analyst- Regulatory and Reporting

WVU MedicineMorgantown, WV, US
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Job Opportunity

We're excited you're considering an opportunity with us! The primary focus of this position is to design reports and analyze data from various sources in order to prepare cost reports and other reimbursement filings as required by regulatory agencies. Extensive knowledge of third-party reimbursement regulations is required in order to file reports accurately and to inform management and other areas of the organization of the impact of changing reimbursement regulations, filings, etc. Excellent communication skills are imperative to coordinate information from various levels of the organization, with Medicare and Medicaid auditors, external vendors, etc. Must be able to use critical thinking and analysis skills, experience, and insight to promptly, accurately, and effectively address issues, questions, complete projects, meet deadlines, etc. without direct management or other leadership involvement. Must be able to operate independently in highly efficient and effective manner.

Minimum Qualifications :

  • Bachelor's Degree. OR
  • HFMA Certified Hospital Cost Report Specialist (CHCRS).

Experience :

  • Successful completion and submission of Medicare Cost reports for two or more (2+) years for Critical Access and / or Acute / IPPS facilities and successful navigation of at least two (2+) years of corresponding reviews, surveys, and audits.
  • Experience with hospital electronic health record systems (EPIC, Cerner, etc.), Cost Reporting applications, general ledger / accounting systems, and CMS / MAC cost reporting procedure, process, completion, submission, supporting schedules and documentation requirements, regulation, strategy, and audit.
  • Advanced computer and spreadsheet skills, primarily in Excel.
  • Preferred Qualifications :

  • Three (3) experience in healthcare accounting (general ledger, trial balance, income statement, balance sheet, cash flow, etc.), finance, revenue cycle, data analysis, and / or reimbursement.
  • Core Duties and Responsibilities :

    The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

  • Prepares and / or supports all third party cost reports and performs any analysis, updates, changes, etc. to facilitate any necessary amendments as needed.
  • Coordinates compiling of all data required for completion of cost reports from various departments systems and external sources.
  • Conducts research and provides documentation and explanations for all necessary workpapers, schedules, and forms.
  • Analyzes data from all sources to ensure accuracy.
  • Assists with and prepares reimbursement budget models with accuracy.
  • Analyzes current rate structure for accuracy and potential opportunities / risk.
  • Maintain and continually improve on technical skills needed to manipulate data.
  • Utilize and develop database report writing skills.
  • Compiles and submits all data for the Medicaid DSH Survey and DSH audit annually.
  • Prepares and analyzes data and compiles supporting documentation for Wage Index and Occupational Mix submissions.
  • Provides necessary data and support to the reimbursement team.
  • Provides analytical interpretation and substantiation during the Hospital's annual financial audit and annual governmental audits.
  • Coordinates reimbursement projects with various consultants.
  • Participates in meeting the objectives of the work unit and goals of the department.
  • Promotes and contributes positively to the teamwork of the department.
  • Participates in performance improvement.
  • Identifies and addresses problems, questions, concerns, analysis, etc. in a timely manner.
  • Provides any other support to the Finance and Reimbursement Department.
  • Physical Requirements :

  • Frequent walking, standing, stooping, kneeling, reaching, pushing, lifting, grasping and feeling are necessary body movements utilized in performing duties through the work shift.
  • 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 in order to communicate effectively.
  • Must have reading and comprehensive ability.
  • Working Environment :

  • Office type environment.
  • Ability to work remotely.
  • Skills and Abilities :

  • Extensive experience in financial analysis and interpretation of federal and state regulations.
  • Specialized knowledge of hospital healthcare reimbursement.
  • Strong communication skills.
  • Excellent analytical, critical thinking, and problem-solving abilities.
  • Effective organizational and time management skills.
  • Proficiency in Microsoft Office Suite and other fundamental computer skills.
  • Ability to work effectively and independently.
  • Additional Job Description :

    Scheduled Weekly Hours : 40

    Shift : Day

    Exempt / Non-Exempt : United States of America (Exempt)

    Company : SYSTEM West Virginia University Health System

    Cost Center : 540 SYSTEM Finance and Reimbursement

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    Reimbursement Analyst • Morgantown, WV, US

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