Sr Reimbursement Analyst

2 weeks ago

Phoenix Arizona, United States CommonSpirit Health Full time
Overview:
CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities:
The Senior Reimbursement Analyst is responsible for providing cost report preparation, cost report appeals, audit preparation and other duties related to the regulatory reimbursement services of Dignity Health. The position maintains current knowledge of Medicare, Medicaid and other State and Federal regulations. The Sr. Reimbursement Analyst interacts with customers and ensures value is delivered and customer satisfaction is achieved. The Sr. Reimbursement Analyst also assists in the improvement of internal business processes and meeting future reimbursement service needs.  The Senior Reimbursement Analyst carries out his/her duties by adhering to the highest standards of ethical and moral conduct, acts in the best interest of Dignity Health and fully supports Dignity Health’s Mission, Philosophy and core values of Collaboration, Dignity, Excellence, Justice, and Stewardship. The Senior Reimbursement Analyst reports to the Reimbursement Managers and/or Directors.  Accountabilities: Prepares interim and annual cost reports for Medicare, Medicaid and other State or Federal agencies for Dignity Health facilities and regions

Calculates periodic adjustments for deductions from revenue, revenue reserves, bad debt and other revenue adjustments related to regulatory reimbursement for all Dignity Health facilities and regions in accordance with Dignity Health policies and procedures

Assist the Reimbursement Managers and/or Directors with recommendations for internal Dignity Health strategy by evaluating current growth, anticipating future needs, and assessing impact of services delivered

Assists in the maintenance of standardized policies and procedures and third party settlement methodologies

Reviews operational reports, identifies opportunities/problems, and makes recommendations for improving processes

Assesses the impact of new products, technology, and processes on the existing organization and makes recommendations for improvement

Qualifications:
Minimum Qualifications: Minimum of five (5) years of experience with all aspects of Medicare and Medicaid (Medi-Cal) regulations monitoring and report processes required

Experience as hospital Reimbursement staff or auditing experiences with Fiscal Intermediary required

Minimum of five (5) years of experience and excellent working knowledge of general accounting, government reimbursement, appeals and audits in a complex organization, and maintaining relationships with internal and external entities such as general accounting, patient accounting, and fiscal intermediaries required

Experience and knowledge of current reimbursement regulations and applications in a complex healthcare environment required

Bachelor’s degree in Business Administration, Accounting or equivalent work experience required

Required at times but very limited

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