**This is a 100%25 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%25 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)