Accounts Receivable Manager
Quick Med Claims, LLC
Senior Reimbursement Analyst, Net Revenue
WVU Medicine
full-time
Posted on:
Location Type: Remote
Location: Remote • Virginia, West Virginia • 🇺🇸 United States
Visit company websiteJob Level
Senior
About the role
- Prepare the annual cost reports for Medicare, Medicaid and TRICARE in accordance with government regulations. Analyze reports for increased reimbursement with an understanding of CCR and their impact on reimbursement.
- Primary contact on assigned hospital audits, work diligently to minimize reimbursement impact to hospital.
- Assessing the monthly cost estimate for necessary changes or material variances relating to hospital operations throughout the year. (CAH only)
- Prepare annual Reimbursement Budget models on assigned hospitals with accuracy using final regulations, and Strata revenue and statistical reports. Serves as a resource to the Reimbursement team.
- Coordinates the completion and preparation of the annual Uniform Report (UFR) for the WV Healthcare Authority. Serves as a resource to the Reimbursement team.
- Understanding of Method II reimbursement and the impact on payments and deductions. (CAH only)
- Understanding of IME/GME, DSH, RHC, bad debts and other medical education programs.
- Look for opportunities to automate and improve current processes with a goal of increasing accuracy and efficiency.
- Analyze monthly contractual reserve estimates and communicate to management material changes to A/R. Prepare journal entries.
- Assist with the training of new analysts on department procedures and systems.
- Prepare Medicaid DSH survey and template for DSH Audits. Also, responsible for the review of DSH audit adjustments for accuracy.
- Primary contact on Wage Index and Occupational Mix audits. Review proposed adjustments from auditors and PUF files for accuracy. (Acute only)
- Update third party reserves and review monthly supplemental and pass through schedules for accuracy. Prepare necessary journal entries.
- Verify and analyze interim rate calculations and final settlements by third party payer for accuracy. Responsible for distributing updated rates to internal departments.
- Promotes and contributes positively to the department by assisting with team members’ questions, contributing ideas and problem solving.
- Takes a leadership role in performance improvement through planning and implementing change; maintaining and improving productivity through attendance; and participation in staff meetings, committee meetings and cross functional group projects.
Requirements
- Bachelor’s Degree in business administration, accounting, or finance.
- Five (5) years’ of experience in finance or accounting.
- Advanced degree or Certification in accounting, finance, or healthcare administration (preferred).
- Experience working in a health care or health system environment (preferred).
- Experience working with CMS and/or Medicare auditors (preferred).
- Experience with EPIC, Workday, Lawson, Strata Jazz and TOYON Absolute software (preferred).
- Advanced computer and spreadsheet skills, primarily in Excel / Advance Excel skills/knowledge needed.
- Good communication skills are necessary to interact effectively with management, staff and external auditors.
- Ability to handle multiple tasks and see each to completion with minimal supervision.
- Experience training new analysts on department procedures and systems.
- Cost reporting experience, financial analysis and interpretation of federal and state regulations.
- Ability to read and write legibly in English; visual and hearing abilities to communicate effectively.
Benefits
- Ability to work remotely
ATS Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
cost reportingfinancial analysisreimbursement budgetingjournal entriescontractual reserve estimatesinterim rate calculationsdata analysisadvanced Excel skillsmethod II reimbursementDSH audit adjustments
Soft skills
communication skillsleadershipproblem solvingteam collaborationorganizational skillstraining and mentoringattention to detailtime managementadaptabilityinitiative
Certifications
Bachelor’s Degree in business administrationBachelor’s Degree in accountingBachelor’s Degree in financeAdvanced degree in accountingAdvanced degree in financeAdvanced degree in healthcare administration
