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Overview Job Summary Performs duties of moderate to high complexity, judgment and scope. Assists the Reimbursement Manager in preparing Medicare and Medicaid cost reports, wage index reviews and other reimbursement analysis. Prepares workpapers to support the cost reports, as well as analyzing the data for accuracy and additional reimbursement opportunities; is a resource to other reimbursement analysts. Preferred Functions
- Prepares and provides necessary information required for the completion of the annual/interim Medicare and Medicaid cost reports
- Supports MAC data requests and audits
- Assist with wage index reviews
- Analyze GME & IME data, including but not limited to cost, residents, FTEs, caps, and per resident amounts, to determine accurate Medicare/Medicaid reimbursement. Work with the IRIS data systems and GME departments to ensure accurate reporting of rotations and other resident data
- Analyze data related to Nursing and Allied Health programs, including but not limited to training costs, resident information, rotation schedules, accreditations, etc. to ensure accurate reporting for Medicare passthrough payments and other reimbursement.
- Perform periodic analysis of organ acquisition costs and organ counts to determine accurate Medicare reimbursement. Work with the transplant and OPO departments to obtain and review data.
- Monitors and reviews government agency bulletins, publications, and the Federal Register to understand proposed and final government statutory and regulatory changes that impact Atrium. Able to analyze the financial and operational impacts of these changes to Atrium.
Essential Functions
- Gathers and maintains the data used in the preparation of the Medicare and Medicaid cost reports and provides to outside consultants as necessary and reviews.
- Oversees the cost report preparation performed by outside consultants and performs initial review prior leadership.
- Reviews wage index and recommends adjustments
- Analyzes the impact of proposed cost report changes and implements approved changes in the work papers and cost reports.
- Prepares the quarterly Medicare/Medicaid cost report settlement estimates and maintains the general reserve binder for the corresponding hospital; is able to revise the models to reflect any regulation changes, as necessary
Physical Requirements Lifting and moving reports and notebooks weighing up to ten pounds. Ability to work under pressure to meet deadlines. Mobility to move freely among departments located in various buildings on and off the main hospital campus, as well as other facilities. Majority of day is spent sitting down. Education, Experience and Certifications Bachelor's degree in accounting, finance or related field is required. Minimum of 7 years of experience in healthcare reimbursement preferred.
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Atrium Health
Dec 04, 2024