Senior Reimbursement Analyst

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities.

This position will prepare, review and file the Medicare and Medicaid cost reports for all Ohio Health entities.

• This position will be responsible for ensuring the appropriate governmental Medicare and Medicaid reimbursement that is received for all of Ohio Health’s entities.
• This position is primarily responsible for the proactive calculations and modeling of new regulatory changes and impacts as well as variance analysis of third-party liability accounts. Provides supporting work papers and documentation for third‑party inquiries.
• This position has supervisory oversight of the Reimbursement Analyst daily work schedule including flow of information, teaching of reimbursement fundamentals and principals, review of work and setting daily priorities.
• This positon supports and works with the Sr. Reimbursement Consultant, Reimbursement Advisor and Manager of Reimbursement as needed on projects and processes.
• The Senior Reimbursement Analyst will learn to become a subject matter expert over time from exposure in the following areas, S‑10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical Education, and Governmental Logs, (HCAP, UPL and Franchise Fee programs in the state of Ohio) as well as special projects as assigned.
• Extensive ongoing engagement of learning of Medicare and Medicaid cost reporting and reimbursement regulatory requirements, both federal and state is required.
• The Senior Reimbursement Analyst is required to use extensive interpersonal skills in communicating with all reimbursement department levels as well as outside departmental contacts at Ohio Health.
• This role functions in a heavily matrixed environment and requires strong prioritization, communication and planning skills.
• This position has a matrix reporting structure and reports directly the Manager of Reimbursement as well as the Sr. Reimbursement Consultant, Reimbursement Advisor and Director of Revenue Reimbursement.

This position will prepare, review and file the Medicare and Medicaid cost reports for all Ohio Health entities.

• Subject matter learning and expert on CMS cost reporting, disproportionate share (DSH), Uncompensated Care, Bad debt reporting, IME/GME, Medicare Wage Index, S‑10 reporting, Tricare and 855’s, Ohio Medicaid, HCAP, UPL and Franchise Fee programs.
• Knowledge of Acute Care Hospitals, Critical Access Hospitals, Sole Community Hospitals and Rural Health Clinics.
• Knowledge of reimbursement in specialty areas such psych, inpatient rehabilitation units, Home Health and Hospice.

Projects as assigned by Director of Revenue and Reimbursement and Manager of Reimbursement.

Provide Director of Revenue and Reimbursement and Manager with updates.

CGS audits and auditors.

Working with our legal vendor for Medicare Appeals.

Working with OHA and CBSA facilities on wage index opportunities.

Special projects / analysis as assigned by the Director of Revenue and Reimbursement and Manager of Reimbursement.

Bachelor's Degree:
Finance (Required)

• BS or BA in Accounting or Finance. Hospital and/or healthcare industry experience.
• Understanding of the CMS prospective payment system and State of Ohio regulations.
• Minimum of 2 years’ experience in the healthcare industry. Strong team development and delegations skills.
• Excellent communication and presentation skills.

CPA, MHA or MBA. Experience with Medicare/Medicaid cost reporting 2‑4 years as a Reimbursement Analyst or similar position(s).

Day

40

Reimbursement

... if your passion is to work in a caring environment

... if you believe that learning is a life‑long process

... if you strive…