Reimbursement Analyst | PAM Health Corporate

Reporting directly to the VP of Reimbursement, the Reimbursement Analyst is responsible for providing accurate information for Medicare, Medicaid and State cost report preparation.

• Analyze regulations and calculate financial impact of changes in reimbursement.
• Track changes of and account for any state supplemental payment programs.
• Assist VP of Reimbursement with inquiries from MAC auditors to address questions related to Medicare bad debt and Medicaid eligibility documentation.
• Conduct monthly settlement reviews; identify aberrations and find solutions; provide impact summary of all reviewed settlement files.
• Help with compliance review for PAM hospitals, including ALOS review for LTACHs and 60% compliance review for IRFs.
• Prepare and analyze Medicare bad debt logs and any other support workpapers for cost report purposes

Leadership

• Inclusiveness: Promotes cooperation, fairness and equity; shows respect for people and their differences; works to understand perspectives of others; demonstrates empathy; brings out the best in others and in his/her team
• Managing Staff: Coaches, evaluates, develops, and inspires staff; sets expectations; recognizes achievements
• Stewardship and Resource Management: Demonstrates accountability and sound judgment in managing company resources; appropriate understanding of confidentiality and company values; adheres to and supports company policies, procedures and safety guidelines
• Problem-Solving: Identifies problems and involves others in seeking solutions; conducts appropriate analysis and searches for best solutions; effectively and efficiently implements appropriate responses to correct problems; responds promptly and effectively to new challenges
• Decision-Making: Makes clear, consistent decisions; acts with integrity in all decisions; distinguishes relevant from irrelevant information; makes timely, appropriate decisions.
• Strategic Planning and Organizing: Understands company vision and aligns priorities; accordingly, measures outcomes; uses feedback to redirect as required; evaluates alternatives; appropriately organizes complex issues to desirable resolution
• Communication: Connects with peers, subordinate employees and all customers; actively listens; clearly and effectively shares information; demonstrates effective oral and written communication skills; negotiates effectively.
• Quality Improvement: Strives for efficient, effective, high-quality performance in self and in the department; delivers timely and accurate results; resilient when responding to matters that are challenging; takes initiative to make improvements
• Leadership: Motivates others; accepts responsibility; maintains high morale in department; develops trust and credibility; expects honest and ethical behavior of self and staff
• Teamwork: Encourages cooperation and collaboration; builds effective teams; works in partnership with others; is flexible; responsive to the needs of others
• Development: Maintains up-to-date skills through involvement with professional organizations and/or continuing education

Customer Service

• Maintains the highest level of customer service via courtesy, compassion and positive communication.
• Promotes the mission and vision of PAM Health within the work environment and the community.
• Respects dignity and confidentiality by adherence to all applicable policies and procedures.

Health and Safety

• Works in a manner that promotes safety, wears clothing appropriate to the performance of the job.
• Participants in OSHA required training.
• Follows universal precautions as appropriate for position; comply with Employee Health requirements for continued employment.
• Reports unsafe practices to management.
• Knows own role in case of an emergency.

Education and Training:    

• Bachelor ‘s degree in Accounting, Finance or Healthcare Management.

Experience:   

• 3 plus years of accounting and/or financial analysis experience in healthcare environment.

Knowledge, Skills, and Abilities:

• Knowledge of Medicare cost report, Medicare, Medicaid and other State and Federal regulations is a plus.
• Strong analytical skills required, including knowledge of patient management information systems, proficient skills in Excel.
• Excellent communication skills.