Reimbursement Analyst/Accounta

Overview

The Reimbursement Analyst/Accountant is responsible for the effective filing of Medicare/Medicaid and other Third Party Cost Reports to maximize the cash flow through the interim rates and final settlement.

Special Instructions

Responsibilities

Files Medicare, Medicaid and other third party cost reports to determine interim rate and periodic interim payments and monitors adequacy of interim rate and recommend alternate arrangements that will improve reimbursement.

            Reviews Federal Register and CCH updates regarding impact of proposed and newly activated regulations; develop and submit comments to appropriate agency and advise administration of exposure and alternative action available.

            Maintain and monitor statistical system to support cost reports.

            Review and revise as necessary, systems used for monthly estimates of allowances and periodically prepares interim cost reports to support the reasonableness of monthly estimates.

            Reviews operation and organization of individual hospitals and corporate structure to determine statistics, billing and other systems resulting in maximum reimbursement.

            Reviews contractual arrangements with physicians and others such as insurance companies and assesses reimbursement impact and recommends alternate arrangements that will improve reimbursement.

            Assists ARH units that are developing and implementing new and revised programs by determining reimbursement impact.

            Monitors the audits performed by intermediaries; assesses the impact of adjustments and determines the reasonableness and acceptability of same; and proposes necessary appeals relating to unacceptable adjustments.

            Participates in the preparation of the monthly financial statement, related exhibits and accompanying memorandums in accordance with generally acceptable accounting principles.

            Participates in the preparation of schedules used by various auditors in their determination of the accuracy of accounting records.

            Participates in the preparation of various tax returns and financial surveys.

            Performs other related duties as assigned

Qualifications

This position requires a B.S. Degree in accounting with minimum of 2 years experience in preparation of Medicare/Medicaid cost reports.