Senior Financial Analyst, Revenue and Reimbursement

• Prepares monthly, quarterly, and annual revenue analysis and reporting across all hospital and specialty group departments.
• Ensures revenue recognized for CCMC and CCSG through the month-end close process is in accordance with contracted terms for services rendered.
• Demonstrates technical knowledge of generally accepted revenue recognition standards specific to the hospital industry.
• Analyzes incoming payment information and communications from payers, physicians, and patients in conjunction with applicable contract terms, reimbursement schedules, government regulations, and internal policies.
• Identifies and investigates revenue variances; prepares written analysis and presents findings to leadership as needed.
• Monitors payer contract performance and identifies opportunities for revenue optimization or recovery.
• Develops productive relationships across Finance departments, including Revenue Cycle, Financial Operations, Financial Reporting, and Contract Management.
• Supports the annual revenue budget process, including preparation of supporting schedules and documentation.
• Provides regular updates to revenue forecasts, incorporating changes in payer mix, utilization trends, contract terms, and regulatory developments.
• Supports new business initiatives with revenue expectations and scenario modeling.
• Assists with establishing physician fee schedules by CPT codes for each cost center and department.
• Supports reimbursement analysis and regulatory compliance monitoring.
• Ensures all actions are consistent with applicable government regulations, contractual terms, and internal policies and procedures.
• Maintains current knowledge of changes to CMS regulations, state Medicaid policy, and managed care reimbursement methodologies.
• Completes various State and Federal reporting requirements in a timely manner.
• Directs the preparation of support materials related to DSH audits and other audit requirements as needed.

• Education:
  
  Bachelor’s degree from accredited college or university.
• Experience:
  
  5 years’ experience in Healthcare Revenue Cycle or Healthcare Finance departments.
• Knowledge:
• ICD-10, CPT coding, and medical terminology.
• Insurance regulations and reimbursement policies, including managed care, Medicare, and Medicaid.
• Generally accepted revenue recognition standards specific to the hospital industry.
• State and Federal reporting requirements applicable to healthcare finance.
• CMS cost report methodology and DSH program requirements.
• Healthcare financial management principles, including budgeting and forecasting.
• Microsoft Word and Excel; experience with healthcare financial systems preferred.
• Skills:
• Strong analytical and financial modeling skills with a high degree of accuracy and attention to detail.
• Proficiency in data analysis, variance reporting, and revenue reconciliation.
• Excellent written and verbal communication skills, including the ability to present financial data clearly to varied audiences.
• Strong organizational and project management skills with the ability to manage multiple deadlines simultaneously.
• Ability to develop and maintain effective working relationships across departments.
• Abilities:
• Ability to interpret and apply complex regulatory requirements, payer contracts, and internal policies.
• Ability to work independently under general supervision while exercising sound judgment.
• Ability to identify problems, analyze root causes, and recommend practical solutions.
• Ability to adapt to changing priorities in a dynamic healthcare environment.
• Commitment to maintaining strict confidentiality of all financial and patient-related information.

Demonstrates expertise in Healthcare Revenue Cycle Management, including revenue analysis, financial modeling, and compliance with regulatory standards. Proficient in ICD-10, CPT coding, and financial reporting, with strong analytical skills to optimize revenue and support budgeting processes.

• Healthcare Revenue Cycle Management
• ICD-10 And CPT Coding
• Financial Modeling And Analysis
• Regulatory Compliance Monitoring
• Revenue Optimization Strategies

• Revenue Analysis
• Financial Reporting
• Data Analysis
• Variance Reporting
• Revenue Reconciliation
• Budgeting And Forecasting
• Healthcare Financial Management
• Contract Management
• Payer Contract Performance Monitoring
• CMS Cost Report Methodology

• Analytical Skills
• Attention To Detail
• Written And Verbal Communication
• Organizational Skills
• Project Management

• Healthcare Finance
• Insurance Regulations
• Managed Care
• Medicare
• Medicaid
• State And Federal Reporting Requirements
• DSH Audits
• Revenue Recognition Standards
• Payer Contracts
• Regulatory Requirements

• Microsoft Word
• Microsoft Excel
• Healthcare Financial Systems