Roper St. Francis Healthcare Sr Reimbursement Analyst in Ladson, South Carolina
The Senior Reimbursement Analyst is responsible for meeting the mandatory reporting requirements of Medicare, SC Medicaid and TRICARE. These responsibilities include the coordination and preparation of the annual cost reports and the supporting documentation, complying with government regulations, assisting in third party audits, checking the accuracy of all data used by third party payers for reimbursement purposes, validating rate changes as initiated by the fiscal intermediary, CMS and/or other regulatory agencies. Responsibilities also include staying abreast of government regulations and monitoring the reimbursement impact of these changes; recommending operational modifications to achieve maximum reimbursement allowed within the scope of the regulations and maintain organizational compliance. Performs monthly government contractual adjustment analysis and prepares the annual government reimbursement projections for the budget. The Senior Reimbursement Analyst performs duties of moderate to high complexity, judgment, and scope. This individual should be able to work independently with a minimal amount of supervision from the Director of Reimbursement Services.
Minimum Qualifications :
Education : Graduation from an accredited four-year institute of higher learning with a degree in accounting, finance or related field.
Experience: At least three to five years experience in financial management or comparable experience in a healthcare environment and/or at least three to five years of healthcare reimbursement experience, of which two years should be in acute hospital reimbursement. Preferred candidate has working financial and CMS reimbursement knowledge of multi-entity corporate structure. Current structure includes a home office, acute care facilities, Inpatient Rehabilitation Facility (IRF) sub-provider, home health agency and CPE. Must be capable of exercising good judgment in areas of moderate to high complexity.
Licensure/Certification: CPA and/or MBA preferred.
Knowledge/Skills Required: Experience and familiarity with CMS Hospital and Home Office Cost Report forms and regulations. Experience with CMS Hospital and Home Office Cost Report software applications. Proficient user of spreadsheet and word processing applications. Proficient user of 10-Key calculator. Possesses above average oral and written communication skills. Is detailed-oriented and is well-organized. Possesses analytical and interpretative expertise. Multi-tasked capability. Ability to establish and maintain effective working relationships
Other: Ability to maintain the confidentiality of sensitive information. Positive attitude, and a willingness to learn and improve. A team player and ability to get along with others. A proactive approach to problem solving and willingness to take initiative.
Contacts: Maintains professional contact with Fiscal Intermediary, CMS, SC Department of Health and Human Services, members of the SC Hospital Association, various consultants and all levels of Roper Saint Francis Healthcare employees.