Reimbursement Analyst -13081
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POST DATE 9/9/2016
END DATE 11/10/2016
West Virginia University Hospital
JOB DESCRIPTIONJOB DESCRIPTION
Reimbursement Analyst (13081)
Nancy L. Repine
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.
SUPERVISORY RESPONSIBILITIES: None
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.
OTHER SKILLS AND ABILITIES: