Senior Reimbursement Analyst

Location: Renton, WA
Date Posted: 05-11-2018
Senior Reimbursement Analyst – Managed Care
Renton, WA (South-Eastern Suburb of Seattle)
Senior Reimbursement Analyst Job Summary: 
  • Responsible for helping manage the financial resources of the region by assist in the preparation and filing Medicare, Medicaid and other cost reports required by third-party payers
  • Assist in coordination of audits, appeals and exception requests related to these payers
  • Assist in contractual allowance and reserve calculations for financial reporting and budgeting
  • Assist in payment trend analyses and reimbursement strategies for various programs within the region.
  • Ensure application of common policies and procedures for reimbursement functions including estimating and reporting third-party reimbursement and reserves that are included in financial reports.
  • Assist in the preparation of monthly and year-end contractual allowance estimates for various third-party payers within the region.
  • Assist in the preparation of reimbursement estimates for the region’s long-range financial plan and annual budget, consistent with approved guidelines and assumptions and with reimbursement and payment trends projected for each of the Regional Acute Care entities.
  • Review the reasonableness of interim reimbursement rates and special payments received from third-party payers and follow-up as appropriate.
  • Assist in the preparation and submission of accurate and timely cost reports as required by Medicare, Medicaid and other third-parties for entities within the region.
  • Assist in coordination of audits of cost reports or other information as required by Medicare and other payers.
  • Assist in identification of Medicare, Medicaid or other reimbursement issues that should be appealed, recommend appropriate outside resources for pursuing appeals
  • Monitor the process to ensure that appeals or exception requests are filed in a timely manner and follow-up to ensure timely resolution. 
Senior Reimbursement Analyst Background: 
  • Requires an education level equivalent of a Bachelor’s degree in Business Administration, Finance, or Accounting.
  • Requires basic customer service skills, as well as very strong computer user skills.
  • At least 1-3 year experience in a medical office, hospital or health plan call center, or other healthcare support role with heavy computer & phone use.
  • Prefer experience with preparation of Medicare and Medicaid cost reports for acute care entities.
  • Advanced computer skills to include Microsoft Word, Excel and basic data entry, including the ability to learn new and complex computer system applications.
CareNational Healthcare Services
623.201.8732 (CALL – TEXT – FAX)
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