Senior Reimbursement Analyst – Regulatory and Reporting

🔥 14 hours ago

🏈 Ohio, Pennsylvania, +1 more states – Remote

🏈 Ohio – Remote 🔔 Pennsylvania – Remote ⛰️ West Virginia – Remote

⏰ Full Time

🟠 Senior

🚔 Compliance

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WVU Medicine

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • 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.

📋 Description

• Design reports and analyze data from various sources to prepare and submit cost reports and reimbursement filings • Provide accurate support and inform management and organizational areas about changing reimbursement regulations • Develop facility and system technical and process improvements, efficiencies, strategies, and modeling • Complete, advise on, submit, and support third-party cost reports and related filings and amendments • Support audits and reviews, including Wage Index, Occupational Mix, DSH, S-10, Bad Debt, Charity Care, NAHE, and DGME/IME • Coordinate data compilation from departmental systems and external sources • Track and communicate filing deadlines, settlements, amendments, audits, adjustments, and reimbursement items • Research and document workpapers, schedules, forms, governing rules, legislation, and reimbursement impacts • Analyze data for accuracy, consistency, technical correctness, regulatory compliance, and audit requirements • Prepare reimbursement budget models and the annual Uniform Report for the WV Healthcare Authority • Analyze rate structures and future impacts; coordinate with the internal Audit team • Develop database report-writing skills in Strata and other systems • Complete, analyze, and submit Medicaid DSH Surveys and DSH audits • Compile supporting documentation for Wage Index, Occupational Mix, transplant, Nursing and Allied Health, Bad Debt, Charity Care, S-10, desk review, and IME/GME Overlap • Provide data and support to calculate third-party receivables and payables • Provide analytical interpretation and substantiation during annual financial and governmental audits • Coordinate reimbursement projects with consultants • Identify problems and implement actions to prevent losses, maximize reimbursement, and meet deadlines • Support Finance and Reimbursement Department activities, performance improvement, quality assurance, and teamwork • Operate independently, replicate prior-year workpapers, and collaborate effectively to fulfill responsibilities

🎯 Requirements

• Bachelor’s Degree OR HFMA Certified Hospital Cost Report Specialist (CHCRS) • Three (3) years of experience in successful completion and submission of Medicare Cost reports for Critical Access and/or Acute/IPPS facilities • Three (3) years of experience with hospital electronic health record systems (EPIC, Cerner, etc.), Cost Reporting applications, general ledger/accounting systems, OR CMS/MAC cost reporting procedure, process, completion, submission, supporting schedules and documentation requirements, regulation, strategy, and audit • Two (2) years of experience with advanced computer and spreadsheet skills, primarily in Excel • Read and write legibly in English • Extensive experience in financial analysis and interpretation of federal and state regulations • Specialized knowledge of hospital healthcare reimbursement, including cost reporting, bad debt, S-10, Wage Index/Occupational Mix, DSH, 340b, and rate setting • Proficiency in Microsoft Office Suite (Excel, Access, Word, Outlook) and other fundamental computer skills • Ability to work effectively and independently in a fast-paced environment • Ability to meet deadlines with precision, intention, and efficiency

🏖️ Benefits

• Ability to work remotely • 40 scheduled weekly hours • Educational opportunities provided by the hospital to enhance skill-related abilities

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