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Reimbursement Analyst -13081

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POST DATE 9/9/2016
END DATE 11/10/2016

West Virginia University Hospital Morgantown, WV

Morgantown, WV
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
Bachelors Degree



Job Title:

Reimbursement Analyst (13081)


Financial Services

Reports To:

Nancy L. Repine

FLSA Status:



September 2015


Education and Experience:

Bachelor s Degree in Business with major in Accounting or Finance

3 years work experience in finance or accounting, preferably in a healthcare setting

Third party reimbursement experience preferred.

Direct experience in cost reporting, financial analysis and interpretation of federal and state regulations required.

Certificates, Licenses, Registrations: None

Knowledge, Skills, Abilities

Good communication skills are necessary to interact effectively with management, staff and external auditors.

Extensive knowledge of personal computers and Excel software is preferred.

SUMMARY: The primary focus of this position is to design reports and analyze data from various sources in order to prepare various cost reports as required by regulatory agencies. Extensive knowledge of third party reimbursement regulations is required in order to file reports accurately and to inform management of the impact of changing reimbursement regulations. Good communication skills are imperative in order to coordinate information from various sources and to coordinate the annual audit.

ESSENTIAL DUTIES AND RESPONSIBILITIES: include the following. Other duties may be assigned.

1. Prepares all third party cost reports (Medicare, WV Medicaid, PA Medicaid, Ohio Medicaid & Champus).

1.1 Coordinate gathering all data required for completion of cost reports from various departments, systems and external sources.

1.2 Analyzes data from all sources to ensure accuracy and consistency.

1.3 Maintains all PC files for cost reports.

1.4 Coordinates the annual Medicare audit.

1.5 Verify and analyze interim rate calculations and final settlements by third party payors for accuracy.

2. Maintain and continually improve on technical skills needed to manipulate data.

2.1 Write PC programs, spreadsheet macros and design data base structures as needed in order to produce and analyze data to produce reports.

2.2 Maintain intermediate report writing skills on Trendstar and other systems as needed.

2.3 Maintains all third party cost report computer software systems, including installing all updates.

3. Review and interpret all new reimbursement legislation and communicate to management.

3.1 Review state and federal regulations and other reimbursement education publications to analyze the reimbursement impact of regulatory changes on the hospital.

3.2 Become an expert on issues related to Medicare and Medicaid reimbursement.

4. Participates in meeting the objectives of the work unit and goals of the department.

4.1 Promotes and contributes positively to the teamwork of the department by assisting co-workers, contributing ideas and problem-solving with co-workers.

4.2 Participates in performance improvement through planning and implementing change and maintaining and improving productivity through attendance and participation in staff meetings, committees, task forces, cross functional groups, projects and discussion with hospital management and staff.

PERFORMANCE STANDARD: Adheres to the established Performance Expectations for WVUH Employees in the areas of People, Service, Performance Improvement, Shared Values & Culture.


PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Frequent walking, standing, stooping, kneeling, reaching, pushing, lifting, grasping and feeling are necessary body movements utilized in performing duties through the work shift.

Must be able to sit for extended periods of time.

Must be able to read and write legibly in English.

Visual acuity must be within normal range.

Must have hearing abilities in order to communicate effectively via telephone and in person.

Must have reading and comprehensive ability.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Office type environment.




WVU Hospitals, a 531-bed tertiary care center, serves as the primary teaching destination for West Virginia University’s health professions schools. We are a member of the West Virginia University Health System.The clinical excellence of WVU Hospitals has been nationally recognized (Level One Trauma Center, Magnet recognition for nursing, etc.), and we are widely considered a leading employer of choice for our employee-friendly environment and approach.WVU Hospitals includes the flagship hospital Ruby Memorial, which houses WVU Medicine Children’s on the sixth floor and the Jon Michael Moore Trauma Center, and also includes Chestnut Ridge Center on the same campus in Morgantown.

Company Size:
5,001-10,000 Employees
Health Care
Social Media:
1 Medical Center Dr
Morgantown, WV 26506

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