Reimbursement Analyst - Audit and Regulatory

April 15

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WVU Medicine

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Healthcare Insurance

WVU Medicine is a comprehensive health system affiliated with West Virginia University, providing medical services through a network of hospitals across West Virginia. The system includes notable facilities such as J. W. Ruby Memorial Hospital, WVU Medicine Children's, and various other regional medical centers. WVU Medicine offers a wide range of healthcare services, including specialized and advanced medical treatments such as robotic heart surgery. It's also involved in medical education, research, and community health initiatives, emphasizing a mission of delivering high-quality care to the communities it serves.

10,000+ employees

⚕️ Healthcare Insurance

📋 Description

• Prepares all third party cost reports and coordinates the audits of these reports. • Coordinates gathering all data required for completion of cost reports from various departments, systems and external sources. • Analyzes data from all sources to ensure accuracy and consistency. • Prepares reimbursement budget models with accuracy using the most current proposed and final regulations. • Prepares the Uniform Report for the WV Healthcare Authority annually and can resolve variances independently. • Verify and analyze interim rate calculations and final settlements by third party payors for accuracy. • Maintain and continually improve on technical skills needed to manipulate data. • Prepares requested data for various consultant reimbursement projects. • Maintain intermediate report writing skills in Strata and other systems as needed. • Maintains all third party cost report computer software systems, including installing all updates. • Reviews state and federal regulations to analyze reimbursement impact of regulatory changes on the hospital. • Compiles all data for the Medicaid DSH Survey and DSH audit annually. • Prepares monthly contractual reserve analysis by gathering necessary data and proposing necessary journal entries. • Prepares data for Wage Index reviews and Occupational Mix surveys as assigned. • Calculates third party receivables and payables monthly. Prepares necessary journal entries and maintains detailed schedules of calculations. • Participates in meeting the objectives of the work unit and goals of the department. • Promotes teamwork by assisting co-workers and contributing ideas.

🎯 Requirements

• Bachelor’s Degree in business administration, accounting, or finance • Three (3) years’ of experience in finance or accounting