Sr. Reimbursement Analyst

NEW HAVEN, CT
Oct 14, 2019

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Job Description

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

Responsible for a variety of revenue analysis activities, including the completion of third party year-end reports, preparation of Hospital's gross and net revenue budgets, monthly net revenue computations and accounting entries to support the financial statement close process, completing the analyses of profitability by payor, routine Office of Health Care Access reporting, and the analysis of regulatory changes as they impact Hospital net revenue. Supports special audits as required. Supports and enhances the compliance effort of the Hospitals and the System. Supports the efforts of the Hospital Business Office in accurate and timely billing and cash collections.

EEO/AA/Disability/Veteran

Responsibilities

  • 1. Leads efforts in the timely and accurate preparation of all ongoing cost analysis and data reports for outside agencies and regulators such as Medicare, OHCA, State of Connecticut Department of Social Services, and the Connecticut Hospital Association. Prepares and maintains underlying records and documents in support of the cost report filings.
  • 2. Maintains advanced knowledge on reimbursement rules, regulations, and policy. Develops ability to contribute as technical advisor on reimbursement issues. Stays abreast of routine developments in Reimbursement, coding and billing regulations, and assists in interpretation and explanation of their potential effect on future Reimbursement efforts and plans.
  • 3. Coordinates and completes the monthly and annual net revenue computations, valuation, accounting and projects and staff associated with same. Includes financial analysis, financial forecasting, recording and assuring the accuracy of accounting entries, reconciliations and investigation of variances as required.
  • 4. Coordinates efforts of multi-disciplinary groups responsible for projects involved in the management and enhancement of Reimbursement, as required. At times, will be expected to lead these groups. Groups may include representatives from various clinical areas, Accounting, Coding, Medical Records, Billing, Utilization Management, Compliance, and Information Systems and staff from other organizations. At other times, is required to work closely with clinical, Compliance and other Finance colleagues on a number of different Reimbursement projects.
  • 5. Maintains the accuracy and accountability of Reimbursement information reported externally to outside auditors, governmental agencies and the public.
  • 6. Supports the efforts of Revenue Enhancement as a participant on governmental appeals, Chargemaster, contract compliance and other projects.
  • 7. Supports the efforts of the Hospital Billing Office in accurate and timely billing and cash collections.
  • 8. Analyzes current Reimbursement information, supporting documentation and data capture methods for purposes of identifying systemic and departmental opportunities for improvement and enhancement.
  • 9. Participates in guidance to and support of administrative or clinical departmental needs on questions, process, status changes or updates to Reimbursement requirements, protocols and regulations.
  • 10. Researches and resolves Reimbursement questions or issues.
  • 11. Participates in communication of routine updates to rates or regulations affecting net revenue to management and affected clinical and administrative departments.
  • 12. Supports and enhances the Compliance efforts of the Hospital and the System.
  • 13. Works on numerous projects simultaneously, and is engaged as lead analyst on several at the same time.
  • 14. Promotes the Corporate philosophy of positive customer relations.
  • 15. Performs other duties as required.

Qualifications

EDUCATION


B.A. or B.S. in Accounting, Finance, Health Care Administration, Mathematics, Information Systems or similar field is required.


EXPERIENCE


A minimum of five years' experience in health care finance, reimbursement, public or other accounting, auditing, budget, compliance, billing or insurance required with progressive responsibility in analysis and project management.


SPECIAL SKILLS


Significant knowledge of governmental reimbursement rules, regulations and accounting and auditing theory is assumed. Assumes working knowledge in the field of health care, including experience with billing, coding and working with clinicians.Assumes prior project management experience, and assumes ability to work independently.Excellent communication skills.


PHYSICAL DEMAND


Located at Corporate office in New Haven with other departmental staff. Direct supervisor will reside part-time in New Haven and part-time at the Hospital, and candidate must have ability to work independently with this type of supervision and project oversight.


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Job Info

Job: 11338

Department: Reimbursement
Category: FINANCE
Sub Category: ADMIN PROF
Status: Full Time Benefits Eligible
Shift: D
Hours: 40

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