Reimbursement Analyst Senior

Job Description

Description

PeaceHealth is seeking a Reimbursement Analyst Senior for a Full Time, Day position.

JOB SUMMARY
This position is a key support staff member to assigned internal customers and as such is responsible for understanding their governmental regulatory reporting needs, completion of regulatory reports, and supporting and furthering their goals and priorities within the context of the goal and priorities of the system Reimbursement team. Responsible for analysis of third party government payer reimbursement for the health system. This includes Medicare, Medicaid, and other Governmental Cost Report filings/audits/appeals, State provider tax programs, and staying current on all Federal and State government regulatory payment changes. Responsible to assist in providing credible and understandable reimbursement analyses and guidance that enhance decision making of assigned internal customers. Services as a resource for Medicare regulatory research and reimbursement analysis for new services, regulatory and legislative change, and strategic planning. Responsible summarizing the governmental reporting and reimbursement impact of regulatory changes.

ESSENTIAL FUNCTIONS

1. Responsible for assigned aspects of third party government payer reimbursement. This includes Medicare, Medicaid, and other Governmental Cost Report filings/audits/appeals, State provider tax programs, and staying current on all Federal and State government regulatory payment changes Completes reports for assigned areas that are mandated by governmental regulations and laws in a timely manner that maintain compliance with regulatory requirements and maximize reimbursement under the respective governmental programs.
2. Completes reimbursement analysis in a timely manner that facilitates and enhances the decision making of the customers and the projects.
3. Facilitates Medicare regulatory changes affecting PeaceHealth to ensure compliance with Federal and State laws and the timely billing of healthcare services to governmental and managed care payors.
4. Provides recommendations for changing wage index reporting in a timely manner to enhance medical and Medicare Managed Care reimbursement.
5. Provides timely summarized information that prepares the organization for upcoming Medicare and Medicaid changes.
6. Continually monitors changes in the regulatory environments with a focus on identifying reimbursement opportunities which may include rural health providers, exempt units, home office cost reports, etc.
7. Performs other duties as assigned.

• Bachelor’s degree in Accounting, Finance, Business Administration or related field required.

• Minimum of five years progressive Medicare reimbursement experience focusing on hospital regulatory reporting required.
• Public accounting firm or Medicare fiscal intermediary experience preferred.

• Current CPA (Certified Public Accountant) certification preferred.

• Must have extensive knowledge of third-party reimbursement rules, regulations and procedures. Demonstrated ability to work efficiently and responsibly in a collaborative environment with multiple work demands and short time frames.
• Strong attention to detail.
• Must be well organized and self-motivated.
• Strong communication skills, both verbal and written.
• Strong analytical, critical thinking and problem solving skills.
• Proficient computer skills including MS Office applications. Strong working knowledge and aptitude for using various software applications. 

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.  

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state, or federal laws.