Analyst, Reimbursement III

Reimbursement Analyst III

HealthPartners is hiring a Reimbursement Analyst III.

The Reimbursement Analyst III is responsible for the preparation of hospital, hospice, home health agency, home office and skilled nursing facility cost reports, support for annual external audit related to net revenue valuation, net accounts receivable valuation, and pay or settlement liabilities. This position is also responsible for maintaining decision support system reimbursement modeling and auditing of same to ensure that calculated net revenues reasonably match actual payments. Other special analysis related to patient services, government regulatory issues and general accounting as assigned.

MINIMUM QUALIFICATIONS:

Education: Bachelor's degree in Accounting or Finance

Experience: 3- 5 years of experience in Medicare cost reporting or related healthcare finance area

Licensure/ Registration/ Certification: None

Knowledge, Skills and Abilities: Advanced knowledge of hospital accounting and Medicare cost accounting fundamentalsKnowledge of accounting, statistics and general business principles and practicesAbility to maintain effective working relationships with othersAbility to communicate effectively both written and oralAbility to handle confidential information with discretionAbility to use a personal computer (Microsoft Office, Excel, PowerPoint) and cost report preparation softwareAbility to work independently with light supervisionAdvanced knowledge of third party reimbursement payment mechanisms and settlement proceduresKnowledge of hospital payor relationships and accounting

MAJOR JOB DUTIES AND TASKS:

1. Evaluation of Net Patient Services Revenue and Accounts Receivable - 10%

Monthly analysis and valuation of net patient services revenue

Interim updating of Medicare and third party settlement liabilities

Quarterly evaluation of net patient accounts receivable and adjustments as required

External Audit resource for documentation needed to audit net patient revenue and net patient accounts receivable valuation

2. Medicare Cost Report Preparation and Audit Support - 50%

Prepare cost reports for Regions and HealthPartners affiliates

Assist the Reimbursement Manager with Medicare audit support as needed

Assist the Reimbursement Manager with the preparation of Medicare appeal Documentation and position paper preparation as needed

3. Decision Support System Modeling and Analysis - 10%

Modeling of Net Revenue Reimbursement for Medicare & Medicaid

Auditing of Decision Support System reimbursement and costing

Analysis of regulatory and program changes using decision support system

4. Other Regulatory Reporting - 20%

Filing of annual Department of Health Hospital Annual Report based on existing State of Minnesota regulations

Filing of annual Department of Health Medical Education and Research Cost grant application based on existing State of Minnesota regulations

Completion of trade association survey data related to patient services revenue and statistical data available from regular analytical records

5. Preparation of annual net patient services revenue budget and associated other operating revenues - 10%

Preparation of assumption driven inpatient and outpatient gross revenue, contractual allowance and net patient services revenue budget based on historical data and business volume changes as communicated by management direction

Prepare analysis for mid year forecasting of net revenue