Sr. Reimbursement Analyst

Number of Positions In Requisition

Job Details

Job Description

Remote position

The Senior Reimbursement Analyst independently performs complex government reimbursement reporting and analysis for assigned hospitals and entities. The position prepares and reviews Medicare and Medicaid cost-report schedules and regulatory submissions develops reimbursement estimates and financial-impact analyses supports audits appeals and settlement activities and interprets regulatory requirements to develop well-supported recommendations for department leadership. The Senior Reimbursement Analyst leads assigned projects and process improvements maintains strong documentation and internal controls collaborates with internal and external stakeholders and provides technical guidance to support accurate timely and compliant reimbursement results.

ESSENTIAL FUNCTIONS

• Prepare and review complex Medicare and Medicaid cost-report schedules reimbursement workpapers and government submissions for assigned hospitals and entities ensuring accuracy complete supporting documentation and compliance with established deadlines and requirements.
• Independently collect validate reconcile and analyze financial statistical and operational data from multiple systems and departmental sources; identify inconsistencies and resolve or escalate issues as appropriate.
• Develop reimbursement estimates forecasts reconciliations variance analyses and financial-impact models; interpret results and present findings and recommendations to department leadership.
• Support cost-report audits reopenings appeals and settlement activities by preparing and reviewing responses workpapers data requests and supporting analyses and by coordinating assigned issues through resolution.
• Research and interpret Medicare and Medicaid regulations payment rules and regulatory guidance; assess financial and operational implications and develop well-supported summaries and recommendations.
• Perform detailed analyses related to disproportionate share hospital payments indirect and direct graduate medical education wage index geographic reclassification supplemental payments and other government reimbursement methodologies.
• Manage assigned components of federal and state reimbursement programs including data collection validation submission preparation reconciliation compliance monitoring financial tracking and communication of results.
• Prepare and review reimbursement assumptions and analyses for the annual operating budget financial forecasts long-range planning period-end close and other financial reporting activities; investigate variances and recommend adjustments.
• Maintain and enhance reimbursement workpapers process documentation reporting standards and internal controls; identify opportunities to improve accuracy efficiency and consistency.
• Lead assigned reimbursement projects and process-improvement initiatives by defining work plans coordinating information across departments monitoring milestones resolving issues and communicating progress and results.
• Collaborate with finance accounting revenue cycle legal compliance operations clinical departments auditors consultants and governmental representatives; provide technical guidance and review support to team members and stakeholders on assigned areas of expertise.

QUALIFICATIONS

Education - Required

• Bachelors degree in accounting finance health administration or a related field.

Experience Required

• 4 years of hospital reimbursement healthcare finance accounting financial analysis or related experience.
• Experience preparing financial analyses reconciliations workpapers or regulatory reports.
• Experience working with spreadsheets and financial or reporting systems to collect organize validate and analyze data.

Knowledge Skills and Abilities Required

• Working knowledge of accounting financial analysis and reimbursement principles; familiarity with Medicare and Medicaid cost reporting and payment methodologies.
• Ability to collect organize validate reconcile and analyze financial statistical and operational data with a high degree of accuracy.
• Ability to research regulations and guidance summarize relevant information apply established procedures and seek direction on complex or unfamiliar matters.
• Knowledge of workpaper preparation documentation standards internal controls audit support and regulatory reporting requirements.
• Strong analytical and problem-solving skills including the ability to identify data inconsistencies investigate variances and communicate findings.
• Ability to organize assignments manage competing priorities meet deadlines follow through on open items and appropriately escalate issues.
• Effective written and verbal communication skills with the ability to explain analyses ask clarifying questions and work productively with internal and external stakeholders.
• Proficiency in spreadsheet applications financial reporting platforms and data-analysis tools used to prepare calculations reconciliations and reports.
• Strong attention to detail organization judgment and commitment to maintaining complete and accurate documentation.
• Ability to collaborate effectively with finance accounting revenue cycle legal compliance operations clinical departments auditors consultants and other partners.

Work Shift

Worker Sub Type

Employee Entity

Primary Location Address

Nationally ranked Jefferson which is principally located in the greater Philadelphia region Lehigh Valley and Northeastern Pennsylvania and southern New Jersey is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65000 people strong dedicated to providing the highest-quality compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrows professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic clinical and applied research. Thomas Jefferson University home of Sidney Kimmel Medical College Jefferson College of Nursing and the Kanbar College of Design Engineering and Commerce dates back to 1824 and today comprises 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8300 students. Jefferson Health nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age race color religion creed sexual orientation gender gender identity marital status pregnancy national origin ancestry citizenship military status veteran status handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues including medical (including prescription) supplemental insurance dental vision life and AD&D insurance short- and long-term disability flexible spending accounts retirement plans tuition assistance as well as voluntary benefits which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues including those who work less than part-time(including per diemcolleagues adjunct faculty and Jeff Temps) have access to medical (including prescription) insurance.

For more benefits information please click here