cropped cropped White with Bold Red Political Logo 1 3733 328 123 305 Reimbursement Analyst

Reimbursement Analyst

  • Full Time
  • San Diego, CA
  • TBD USD / Year
  • WVU Medicine profile




  • Job applications may no longer being accepted for this opportunity.


WVU Medicine

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full.  Below, you’ll find other important information about this position. 
The primary focus of this position is to design reports and analyze data from various sources in order to prepare various cost reports as required by regulatory agencies. Extensive knowledge of third party reimbursement regulations is required in order to file reports accurately and to inform management of the impact of changing reimbursement regulations. Good communication skills are imperative in order to coordinate information from various sources and to coordinate the annual audit.

MINIMUM QUALIFICATIONS:
EXPERIENCE, EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor’s Degree in business with major in Accounting, Finance or related field AND Three (3) years’ work experience in finance or accounting
OR
Master’s degree in business with major in Accounting, Finance or related field within one (1) year of hire AND One (1) year work experience in finance or accounting

PREFERRED QUALIFICATIONS:
EXPERIENCE:
1. Experience in a healthcare setting.
2. Third party reimbursement experience

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.

1. Prepares all third party cost reports (Medicare, WV Medicaid, PA Medicaid, Ohio Medicaid & Champus) and amends any cost report as needed. Coordinates audits.
2. Coordinates gathering all data required for completion of cost reports from various departments, systems and external sources.
3. Analyzes data from all sources to ensure accuracy and consistency.
4. Prepares reimbursement budget models with accuracy using the most current proposed and final regulations.
5. Prepares the Uniform Report for the WV Healthcare Authority annually and gathers all data for the financial disclosure requirements.
6.Verifies and analyzes interim rate calculations and final settlements by third party payors for accuracy.
7. Maintains and continually improves on technical skills needed to manipulate data.
8. Works with consultants on various reimbursement projects. Prepares requested data, reviews for accuracy and communicates effectively to complete projects timely.
9. Maintains intermediate report writing skills in Strata and other systems as needed.
10. Maintains all third party cost report computer software systems, including installing all updates.
11. Reviews and interprets all new reimbursement legislation and communicate to management.
12. Reviews state and federal regulations and other reimbursement education publications to analyze the reimbursement impact of regulatory changes on the hospital and become an expert on issues related to Medicare and Medicaid reimbursement.
13. Compiles all data for the Medicaid DSH Survey and DSH audit annually. Reviews all DSH audit adjustments for accuracy.
14. Prepares monthly contractual reserve analysis by gathering all necessary data, manipulating the data, reviewing for accuracy and proposing necessary journal entries.
15. Prepares data for Wage Index reviews and Occupational Mix surveys. Answers all questions during the review of these items and analyzes all proposed adjustments from Medicare.
16. Calculates third party receivables and payables monthly. Prepares any necessary journal entries and maintains detailed schedules of all calculations.
17. Participates in meeting the objectives of the work unit and goals of the department.
18. Promotes and contributes positively to the teamwork of the department by assisting co-workers, contributing ideas and problem-solving with co-workers.
19. Participates in performance improvement through planning and implementing change and maintaining and improving productivity through attendance and participation in staff meetings, committees, task forces, cross functional groups, projects and discussion with hospital management and staff.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, lifting, grasping and feeling are necessary body movements utilized in performing duties through the work shift.
2. Must be able to sit for extended periods of time.
3. Must be able to read and write legibly in English.
4. Visual acuity must be within normal range.
5. Must have hearing abilities in order to communicate effectively via telephone and in person.
6. Must have reading and comprehensive ability.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Office type environment.

SKILLS AND ABILITIES:

1. Direct experience in cost reporting, financial analysis and interpretation of federal and state
2. Good communication skills are necessary to interact effectively with management, staff and external auditors.
3. Extensive knowledge of personal computers and Excel

MINIMUM QUALIFICATIONS:
EXPERIENCE, EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor’s Degree in business with major in Accounting, Finance or related field AND Three (3) years’ work experience in finance or accounting
OR
Master’s degree in business with major in Accounting, Finance or related field within one (1) year of hire AND One (1) year work experience in finance or accounting

PREFERRED QUALIFICATIONS:
EXPERIENCE:
1. Experience in a healthcare setting.
2. Third party reimbursement experience

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.

1. Prepares all third party cost reports (Medicare, WV Medicaid, PA Medicaid, Ohio Medicaid & Champus) and amends any cost report as needed. Coordinates audits.
2. Coordinates gathering all data required for completion of cost reports from various departments, systems and external sources.
3. Analyzes data from all sources to ensure accuracy and consistency.
4. Prepares reimbursement budget models with accuracy using the most current proposed and final regulations.
5. Prepares the Uniform Report for the WV Healthcare Authority annually and gathers all data for the financial disclosure requirements.
6.Verifies and analyzes interim rate calculations and final settlements by third party payors for accuracy.
7. Maintains and continually improves on technical skills needed to manipulate data.
8. Works with consultants on various reimbursement projects. Prepares requested data, reviews for accuracy and communicates effectively to complete projects timely.
9. Maintains intermediate report writing skills in Strata and other systems as needed.
10. Maintains all third party cost report computer software systems, including installing all updates.
11. Reviews and interprets all new reimbursement legislation and communicate to management.
12. Reviews state and federal regulations and other reimbursement education publications to analyze the reimbursement impact of regulatory changes on the hospital and become an expert on issues related to Medicare and Medicaid reimbursement.
13. Compiles all data for the Medicaid DSH Survey and DSH audit annually. Reviews all DSH audit adjustments for accuracy.
14. Prepares monthly contractual reserve analysis by gathering all necessary data, manipulating the data, reviewing for accuracy and proposing necessary journal entries.
15. Prepares data for Wage Index reviews and Occupational Mix surveys. Answers all questions during the review of these items and analyzes all proposed adjustments from Medicare.
16. Calculates third party receivables and payables monthly. Prepares any necessary journal entries and maintains detailed schedules of all calculations.
17. Participates in meeting the objectives of the work unit and goals of the department.
18. Promotes and contributes positively to the teamwork of the department by assisting co-workers, contributing ideas and problem-solving with co-workers.
19. Participates in performance improvement through planning and implementing change and maintaining and improving productivity through attendance and participation in staff meetings, committees, task forces, cross functional groups, projects and discussion with hospital management and staff.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, lifting, grasping and feeling are necessary body movements utilized in performing duties through the work shift.
2. Must be able to sit for extended periods of time.
3. Must be able to read and write legibly in English.
4. Visual acuity must be within normal range.
5. Must have hearing abilities in order to communicate effectively via telephone and in person.
6. Must have reading and comprehensive ability.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Office type environment.

SKILLS AND ABILITIES:

1. Direct experience in cost reporting, financial analysis and interpretation of federal and state
2. Good communication skills are necessary to interact effectively with management, staff and external auditors.
3. Extensive knowledge of personal computers and Excel

Scheduled Weekly Hours: 40

Shift:

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

Company: WVUH West Virginia University Hospitals

Cost Center: 540 SYSTEM Finance and Reimbursement

Address: Morgantown WV

Core

West Virginia

To apply for this job please visit wvumedicine.wd1.myworkdayjobs.com.


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