Reimbursement Analyst III

• Work Schedule: 8-5 MF
• Hours Per Week/FTE: 40 hrs weekly / 1.0 FTE
• Job Shift: Day
• Position Type: Full-time regular
• Job Category: Accounting/Finance
• Department: CD Financial Planning and Analysis
• Pay Range: $42.15 - $63.23 hourly
• Pay Range Statement: Compensation is based on the level and requirements of the role. Pay within our ranges may also be determined by education, experience, knowledge, skills, location, and abilities as well as internal equity. Hired candidates may be eligible to receive additional compensation based on role (e.g., shift differential, bonus, sales incentive, productivity pay, etc.).
• Overtime Eligibility Status: Exempt

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 fundamentals
• Knowledge of accounting, statistics and general business principles and practices
• Ability to maintain effective working relationships with others
• Ability to communicate effectively both written and oral
• Ability to handle confidential information with discretion
• Ability to use a personal computer (Microsoft Office, Excel, PowerPoint) and cost report preparation software
• Ability to work independently with light supervision
• Advanced knowledge of third party reimbursement payment mechanisms and settlement procedures
• Knowledge of hospital payor relationships and accounting

MAJOR JOB DUTIES AND TASKS:

Percentage

Of Time:

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

1. Monthly analysis and valuation of net patient services revenue

1. Interim updating of Medicare and third party settlement liabilities

1. Quarterly evaluation of net patient accounts receivable and adjustments as

required

1. 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%

1. Prepare cost reports for Regions and HealthPartners affiliates

1. Assist the Reimbursement Manager with Medicare audit support as needed

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

3. Decision Support System Modeling and Analysis 10%

1. Modeling of Net Revenue Reimbursement for Medicare & Medicaid

1. Auditing of Decision Support System reimbursement and costing

1. Analysis of regulatory and program changes using decision support system

4. Other Regulatory Reporting 20%

1. Filing of annual Department of Health Hospital Annual Report based on existing

State of Minnesota regulations

1. Filing of annual Department of Health Medical Education and Research Cost

grant application based on existing State of Minnesota regulations

1. 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%

1. 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

1. Prepare analysis for mid year forecasting of net revenue