Essential Functions

• Maintain up-to-date knowledge of Medicare / Medicaid rules and regulations
• Working alongside staff in general accounting, assist with new reporting and modeling tools, budget preparation and reimbursement analysis for new product lines
• coordinates the reimbursement section’s input into the annual financial audit performed by the health care facilities outside audit firm
• Liaison with OHA on Reimbursement matters
• Resource to Government Relations for review of proposed regs impacting the hospital.
• Resource relating to appeals, prior year issues, current year reports needed for the cost report and general historical information
• Under limited supervision, preforms Calculation of Net Revenue Reimbursement for the Health System, including allocations. Maintains cost accounting methodologies (RVU, RCC, Variable Charge, ABC), including overhead allocations and statistical drivers.
• Monitors and recommends enhancements to data extracts from source systems. Ensures integrity and validity of data is intact.
• Works closely with IT on system upgrades and testing (beta development, functionality testing, and movement into production environment).
• Develops reporting solutions and analyses for management and senior leadership. Works with Finance and Administrative Leadership to build custom reporting solutions including monthly/weekly/daily reporting, in a repeatable fashion.
• Special projects as assigned (e.g. Product Line Reporting, Profitability Reporting, Physician Based Reporting, business planning data requests, system enhancements). Ad-hoc reporting requests with varying time sensitivity and criticality.

Education

• Bachelor's Degree in Accounting or Finance required

Work Experience

• 1 year experience in accounting experience required, 5+ years accounting experience preferred
• Experience with supplemental revenue reimbursement experience and knowledge of UPL and HCAP and payment rates strongly preferred
• Medicare and Medicaid Cost Reporting experience required
• Health care accounting experience preferred

Knowledge, Skills, & Abilities

• Must possess strong analytical and problem-solving skills. Required
• Knowledge of financial systems including decision support systems, cost accounting, and Oracle Financials/general ledger systems. Preferred
• Knowledge of MS Office Excel intermediate to advanced skills. Required
• MS Office Access knowledge. Preferred
• Demonstrates a professional demeanor when responding to internal and external customers. Required
• Strong interpersonal and communication skills both verbal and written. Required
• Strong work ethic and good organizational skills. Required
• Team player with ability to multi-task in a fast-paced environment is essential to success. Required
• Special project oriented. Required
• Familiar with healthcare operations and budget process extremely beneficial. Preferred
• Self-Motivated. Required
• Enjoys being challenged. Required
• Willingness to learn and grow within current role. Required
• Understanding of charge master and hospital billing is . Preferred
• Knowledge of reimbursement and managed care contracts. Preferred

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