Overview
Reimbursement Analyst – Senior Jobs in City of Rochester, USA at Dormont Manufacturing Co
Location: City of Rochester
Job Title: Reimbursement Analyst
– Senior
Department: Hospital Reimbursement
Location: Hybrid (Onsite & Remote), Riedman Campus, 100 Kings Highway, Rochester, NY
Hours Per Week: 40
Schedule: Full-Time, Day Shift, Monday
– Friday, 8 am to 4.30 pm
Key Responsibilities Reimbursement Expertise
- Provide and maintain hospital reimbursement expertise as it relates to Medicare, Blue Cross and Medicaid (as observed by the Assistant Controller and Controller).
- Study and comprehend reimbursement regulations and attend reimbursement seminars to maintain knowledge of regulations and current issues.
- Train and educate accounting department and other hospital employees in the technical aspects of reimbursement.
- Relate reimbursement knowledge to hospital operations and make recommendations on how to maximize reimbursement. Identify amenable items that could enhance reimbursement and prepare and submit appeals.
Compliance Reporting
- Accurately prepare and submit the annual institutional cost report, physician questionnaire, and other third‑party information requests in compliance with applicable instructions (as observed by the Assistant Controller, Controller, and supported by third‑party payer audits).
- Coordinate third‑party pay or field audits, responding to all audit inquiries and investigating all audit findings. Make recommendations as to whether the third‑party audit findings are in compliance with reimbursement regulations.
Revenue Calculation
- Accurately calculate and record hospital inpatient and outpatient revenues on a monthly basis.
- Accurately calculate net patient service revenue (inpatient and outpatient) on a monthly basis for inclusion in the monthly financial statements within 1% of total revenue.
- Maintain revenue files on the computer system that enable calculation of revenue per DRG. Data is used for management informational purposes.
- Ensure rates used in issuing patient bills are the most recent certified and approved rates by regulatory agencies.
Perform other duties as assigned.
Minimum Qualifications
- BA in Accounting or Business, with prior reimbursement experience or an equivalent combination of education and work experience.
- 3 to 5 years of prior reimbursement experience with demonstrated progressive levels of responsibility.
- Strong analytical, computer, and communication skills.
Required
Licensure/Certification Skills
- None
Physical Requirements
Sedentary work:
Exerting up to 10 pounds of force occasionally. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.
Pay Range
$70,000.00 – $90,000.00
EEO Statement
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.
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Title: Reimbursement Analyst – Senior
Company: Dormont Manufacturing Co
Location: City of Rochester, USA
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