Senior Reimbursement Analyst at St. Mary's Healthcare in Amsterdam, New York

Job Description:

Job Requisition: REQ1151
Employment Type: Full-Time
Shift: Days
Hours Per Week: 40 hours

Responsibilities:

• Review monthly reserves for contractual allowances developed using the RCA Crowe net revenue valuation tool. Post necessary adjustments to the general ledger and reconciles the third-party reserve monthly.

• Prepares monthly net revenue reasonableness reporting detailing specific volume and rate variance driving monthly budget variance in net patient service revenue.

• Assist with analysis and understanding of government and commercial reimbursement, including third party settlement modeling, regulatory reporting, and cost report settlements. Ensures adequate reserves for settlements are in place.

• Direct the development and execution of analytical activities to provide senior leadership with information and tools for strategic decision making and planning to include health care utilization and costs analysis, reimbursement projects, forecasting and proforma service line analysis.

• Analyzes internal data and financial trends. Assesses financial risks, establishes, and monitors risk mitigation plans relative to revenue cycle and reimbursement. Examples would include MDH and DSH eligibility requirement tracking and monitoring.

• Assist with entities net patient revenue budget and proactively analyzes reimbursement regulation impacts.

• Participates in due diligence efforts and new acquisition evaluation via review, revision and recommendations related to cost and charging structures and revenue enhancement opportunities.

• Drive revenue cycle improvements through detailed analysis revenue cycle activities including historical write-off history, point of sale cash collections aging of receivable due to unbilled and undocumented claims.

Competency Requirements:

• Strong analytical skills and the ability to work independently.

• Detail oriented and demonstrates a "can-do" attitude.

• Ability to work cooperatively with others in a team environment.

• Solid organizational skills and ability to effectively manage multiple priorities or reprioritization of projects.

Complexity of Work:

• Within scope of job, requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment.

Desired Qualifications Licensure / Certification / Registration:

• Bachelor's degree in Business Administration, Finance, Accounting, or related area required.

• Master's degree, CPA or FHFMA preferred.

• 5+ years' relevant work experience in healthcare financial management including revenue modeling and CMS cost reporting

• Medicare and NYS cost reporting experience preferred

• Meditech ERM experience preferred

Personal Protective Equipment:

• Follows Standard Precautions using personal protective equipment as required.

Job Location:• Amsterdam, NY. Not a remote position.

Reports to: Chief Financial Officer