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Role Description

This role involves analyzing and preparing documentation for Medicare and Medicaid cost reports.

• Collects and 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.
• Prepares additional provider research files and reviews outside consultant logs for the Medicare cost report Medicaid DSH eligibility.
• Prepares Medicare cost reports for Traditional Medicare Bad Debt and Dual Eligible logs.
• Prepares the Medicare cost report Wage Index and reviews audit adjustments for accuracy.
• Prepares calculation of accounts receivable and third-party reserves, including timely submission of monthly journal entries and additional analyses as needed.
• Collects and analyzes all underlying data and prepares 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 submission for the Inpatient Rehab Unit 75% compliance report for exemption from the Inpatient Prospective Payment System.
• Collects and analyzes all underlying data, prepares supporting documentation, and submits Medicare occupational mix surveys in a timely and accurate manner.
• Prepares HCAP logs and obtains supporting documentation for independent consultant review.
• Prepares Myers & Stauffer logs for 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.

Qualifications

• Bachelor's Degree in Business Administration majoring in Accounting, Finance or related business field required.

Requirements

• 3-5 years of job-related experience required.
• Hospital reimbursement experience required, including Medicare and Medicaid cost report experience.
• 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).