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The Reimbursement Analyst Senior is responsible for compiling the information needed for claims submissions. Serves as a central resource for reimbursement analyses, audit and assists with the annual cost report preparation and other reporting requirements. Assists in building financial processes/models to estimate Medicare GME and other reimbursements based on current regulations and specific client circumstances. Provides and interprets reimbursement patterns and trend analyses for various departments. Provides guidance and support to junior team members as needed.

GENERAL DUTIES

Assists in the preparation of accurate government regulatory reports, including year end and interim Medicare/Medicaid cost reports for submission to the intermediary, within a designated timeframe:

• Assists in preparation of Medicare, Medicaid and CHAMPUS annual cost reports.
• Computes interim Medicare/Medicaid settlements and impact on reimbursement for the hospital.
• Provides support and documentation needed by various auditors such as independent, Medicare and Medicaid.
• Assists in providing all data and/or special reports and projects for Medicare/Medicaid appeals and/or reopening.
• Stays up to date on changes to Medicare reimbursement in general and specifically federal regulations related to graduate medical education (GME) and providing education about their impact to other team members and clients.

Analyzes financial data. Designs and generates reports for management's use in operational decisions regarding new and existing programs:

• Directs the preparation of reimbursement studies as needed by senior management.
• Researches regulations related to the implementation of new programs, services, and ventures, and for developing techniques for maximizing reimbursement.
• Develops techniques for effective analysis of billing and collections efforts.

Develops, prepares & presents financial impact of all new & proposed Medicare / Medicaid regulations to Senior Management:

• Evaluates interim payments from the third-party payers for accuracy & adequate cash flow.
• Coordinates with appropriate teams for the production of reports for cost reporting/cost analyses purposes.
• Reviews generally accepted accounting principles & auditing standards as they apply to the reimbursement area.

Assists in the development of contractual allowances for budget projections:

• Assists in the development of contractual allowances for budget projections.

EXPERIENCE QUALIFICATIONS

8 years government healthcare reimbursement and accounting experience in a healthcare setting

Experience and analytical skills related to case mix/reimbursement systems

Experience and knowledge with CMS PRM regulations manuals, the CMS 2552 software system and the CMS IACS/EIDM system

Experience with Medicare IRIS reporting system.

Experience with electronic cost reporting software systems

EDUCATION QUALIFICATIONS

BA In Business Administration or Accounting

SKILLS AND ABILITIES

PC skills (Excel, Access Word, PowerPoint).

Familiarity with EDP and microcomputer systems.

Comprehensive knowledge of Medicare. Medicaid reimbursement principles relating to Home Office, Hospitals, Nursing Homes and Home Health agencies.

REPORTING RELATIONSHIPS

• Does this position formally supervise employees? No

WORK SHIFT:

LCMC Health is a community. 

Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary

Your extras

• Deliver healthcare with heart. 
• Give people a reason to smile. 
• Put a little love in your work. 
• Be honest and real, but with compassion.  
• Bring some lagniappe into everything you do. 
• Forget one-size-fits-all, think one-of-a-kind care. 
• See opportunities, not problems – it’s all about perspective. 
• Cheerlead ideas, differences, and each other. 
• Love what makes you, you - because we do

You are welcome here. 

LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.

The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities.  LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.

Simple things make the difference. 

1.    To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information. 

2.    To ensure quality care and service, we may use information on your application to verify your previous employment and background.  

3.    To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed. 

4.    To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.