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Senior Reimbursement Analyst – Regulatory and Reporting
WVU Medicine. Design reports and analyze data from various sources to prepare and submit cost reports and reimbursement filings .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in hospital healthcare reimbursement processes, including cost reporting and regulatory compliance, while effectively analyzing data and preparing accurate financial reports. Proficient in utilizing advanced computer skills and collaborating with various departments to maximize reimbursement and meet deadlines.
Highest-signal resume keywords
Medicare Cost ReportingFinancial AnalysisHospital Electronic Health Record SystemsAdvanced Excel SkillsHealthcare Reimbursement Regulations
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
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Hard Skills
Cost ReportingData AnalysisRegulatory ComplianceFinancial InterpretationDatabase Report-WritingBudget ModelingWage Index AnalysisOccupational Mix ReportingDSH AuditsSupporting Schedules Documentation
Soft Skills
Effective CommunicationIndependent WorkTeam CollaborationDeadline ManagementProblem-Solving
Tools & Technologies
Microsoft Office SuiteEPICCernerCost Reporting ApplicationsGeneral Ledger Systems
Certifications & Qualifications
Bachelor's DegreeHFMA Certified Hospital Cost Report Specialist (CHCRS)
Industry Keywords
Healthcare ReimbursementBad DebtS-10DSH340bRate SettingAudit RequirementsFinancial AuditsPerformance ImprovementQuality Assurance
About the role
Key responsibilities & impact- Design reports and analyze data from various sources to prepare and submit cost reports and reimbursement filings
- Provide accurate support and inform management and organizational areas about changing reimbursement regulations
- Develop facility and system technical and process improvements, efficiencies, strategies, and modeling
- Complete, advise on, submit, and support third-party cost reports and related filings and amendments
- Support audits and reviews, including Wage Index, Occupational Mix, DSH, S-10, Bad Debt, Charity Care, NAHE, and DGME/IME
- Coordinate data compilation from departmental systems and external sources
- Track and communicate filing deadlines, settlements, amendments, audits, adjustments, and reimbursement items
- Research and document workpapers, schedules, forms, governing rules, legislation, and reimbursement impacts
- Analyze data for accuracy, consistency, technical correctness, regulatory compliance, and audit requirements
- Prepare reimbursement budget models and the annual Uniform Report for the WV Healthcare Authority
- Analyze rate structures and future impacts; coordinate with the internal Audit team
- Develop database report-writing skills in Strata and other systems
- Complete, analyze, and submit Medicaid DSH Surveys and DSH audits
- Compile supporting documentation for Wage Index, Occupational Mix, transplant, Nursing and Allied Health, Bad Debt, Charity Care, S-10, desk review, and IME/GME Overlap
- Provide data and support to calculate third-party receivables and payables
- Provide analytical interpretation and substantiation during annual financial and governmental audits
- Coordinate reimbursement projects with consultants
- Identify problems and implement actions to prevent losses, maximize reimbursement, and meet deadlines
- Support Finance and Reimbursement Department activities, performance improvement, quality assurance, and teamwork
- Operate independently, replicate prior-year workpapers, and collaborate effectively to fulfill responsibilities
Requirements
What you’ll need- Bachelor’s Degree OR HFMA Certified Hospital Cost Report Specialist (CHCRS)
- Three (3) years of experience in successful completion and submission of Medicare Cost reports for Critical Access and/or Acute/IPPS facilities
- Three (3) years of experience with hospital electronic health record systems (EPIC, Cerner, etc.), Cost Reporting applications, general ledger/accounting systems, OR CMS/MAC cost reporting procedure, process, completion, submission, supporting schedules and documentation requirements, regulation, strategy, and audit
- Two (2) years of experience with advanced computer and spreadsheet skills, primarily in Excel
- Read and write legibly in English
- Extensive experience in financial analysis and interpretation of federal and state regulations
- Specialized knowledge of hospital healthcare reimbursement, including cost reporting, bad debt, S-10, Wage Index/Occupational Mix, DSH, 340b, and rate setting
- Proficiency in Microsoft Office Suite (Excel, Access, Word, Outlook) and other fundamental computer skills
- Ability to work effectively and independently in a fast-paced environment
- Ability to meet deadlines with precision, intention, and efficiency
Benefits
Comp & perks- Ability to work remotely
- 40 scheduled weekly hours
- Educational opportunities provided by the hospital to enhance skill-related abilities