This is a Fully Remote Job
About Our Client:
The organization operates within the healthcare finance sector, focusing on managing complex reimbursement processes related to Medicare and Medicaid programs. It addresses challenges in navigating federal and state healthcare regulations, cost reporting, and financial settlements to optimize hospital reimbursement. The organization supports multiple hospitals and emphasizes collaboration across finance, revenue cycle, operations, government relations, and executive leadership to achieve strategic goals.
About the Opportunity:
The REIMBURSEMENT SENIOR ANALYST plays a critical role in managing and analyzing reimbursement processes for Medicare and Medicaid, ensuring accurate financial reporting and maximizing reimbursement. This position impacts the organization's financial health by interpreting healthcare regulations, preparing cost reports and settlements, and coordinating with various departments and external agencies. The role requires independent problem-solving and contributes to the organization's ability to meet regulatory and financial deadlines.
Responsibilities:
Prepare and review third-party financial accounting, contractual allowances, cost reports, and surveys.
Perform routine and complex reimbursement tasks with minimal supervision.
Reconcile general ledger accounts and monitor claims.
Prepare monthly Medicare and Medicaid settlement and policy reserve calculations.
Review audit adjustments, settlements, and file appeals to maximize reimbursement.
Mentor and potentially coordinate training for reimbursement staff.
Stay current on reimbursement laws and regulations and assess their impact.
Manage project scope, schedules, and deliverables related to reimbursement.
Communicate reimbursement changes and financial analyses to leadership.
Manage responsibilities across two or more hospitals or a hospital and central office assignments.
Requirements:
Bachelor’s degree in accounting, finance, or related business field with four years of experience, or master’s degree with two years of experience from an accredited institution.
Proficiency with spreadsheets, databases, word processing, and internet.
Experience with Medicare and Medicaid reimbursement methodologies, hospital cost reporting, financial modeling, data analytics, audit processes, and reimbursement settlements.
Ability to interpret and apply complex federal and state healthcare regulations.
Pay Range and Compensation Package:
The hourly rate for this position ranges from $34.26 to $53.96, dependent upon experience.
Equal Opportunity Statement:
Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.