Finance Reimbursement Consultant (HS)

The Ohio State University

6d

About The Position

Responsible for preparation and review of third-party report filings, including cost reports, appeals and payment calculations, for a large academic Medical Center with over 550 GME/IME FTE's, $23,000,000 of Medicare DSH reimbursement, and a TEFRA Cancer Exempt Hospital. The Reimbursement Consultant reviews monthly analysis of contractual and bad debt allowance accounts, including comparisons to the prior month and to budget. Responsible for the maintenance and development of payment factors, costing ratios and reporting formats. The position performs variance analysis of third-party liability accounts. Also, provides supporting work papers and documentation for third-party inquiries along with reimbursement and regulatory analysis on Health System projects. Also, manages workflow processes, projects, and cost report filings for Medicare, Medicaid, and Tricare. The Reimbursement Consultant must have the ability to articulate complex reimbursement healthcare concepts in a simplified manner to departmental and Sr. business unit leadership with regards to month end close and strategic projects throughout the organization. Also, responsible for preparing the annual forecast of the third-party reimbursement factors for the budget. Responsible for the maintenance and development of payment factors, costing ratios and reporting formats. This position provides reimbursement and regulatory analysis on Health System projects. Also, assists in evaluating the cost/quality and feasibility of new and existing programs. This position manages workflow processes and projects and department clerical associates and Student employee associates. Under the supervision of the Administrative Director of Reimbursement, the Reimbursement Consultant is responsible for the annual filing of third-party cost reports and providing financial analysis for special projects. The Reimbursement Consultant also is responsible for achieving accurate third-party reimbursement.

Requirements

• Bachelors degree in Business Administration or related field with a major in Accounting or Finance
• 6 years of hospital reimbursement experience
• Candidates should demonstrate strong technical proficiency in Microsoft Office (including Excel, Access, Word, and PowerPoint), patient accounting systems (EPIC/IHIS preferred), and HFS cost reporting software

Nice To Haves

• A CPA certification or a Master’s degree is preferred, as well as HFMA certification

Responsibilities

• Preparation and review of third-party report filings, including cost reports, appeals and payment calculations
• Reviews monthly analysis of contractual and bad debt allowance accounts, including comparisons to the prior month and to budget
• Maintenance and development of payment factors, costing ratios and reporting formats
• Performs variance analysis of third-party liability accounts
• Provides supporting work papers and documentation for third-party inquiries
• Provides reimbursement and regulatory analysis on Health System projects
• Manages workflow processes, projects, and cost report filings for Medicare, Medicaid, and Tricare
• Prepares the annual forecast of the third-party reimbursement factors for the budget
• Assists in evaluating the cost/quality and feasibility of new and existing programs
• Manages workflow processes and projects and department clerical associates and Student employee associates
• Responsible for the annual filing of third-party cost reports and providing financial analysis for special projects
• Responsible for achieving accurate third-party reimbursement

Benefits

• An array of retirement plan options, each with a generous employer contribution.
• Affordable health insurance options, including dental, vision and prescription coverage that begin on day one.
• Paid vacation and sick leave, including short and long-term disability and paid parental leave.
• Get the most out of the Public Service Loan Forgiveness program.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level