Reimbursement Analyst

Job Description

ECU Health

ECU Health

About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children's Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.

Position Summary

The Reimbursement Analyst is responsible for the integrity of net revenue and providing cost report preparation, cost report appeals, audit preparation and other duties related to the regulatory reimbursement services of ECU Health. The position maintains current knowledge of Medicare, Medicaid and other State and Federal regulations. The Reimbursement Analyst interacts with customers and ensures value is delivered and customer satisfaction is achieved. Assists in coordination of net revenue functions related to the strategic financial planning process. The Reimbursement Analyst also assists in the improvement of internal business processes and meeting future reimbursement service needs.

Responsibilities

1. Assures projects run smoothly.
   
   Requests feedback to ensure department is meeting customer requirements.
   
   Assigns, prioritizes, and coordinates projects. Provides directions and guidance to other analysts to ensure adequate project completion.
   
   Demonstrates initiative in identifying opportunities for self-development and enhanced professional competency.
2. Prepares and timely files the annual cost reports for all the entities of ECU Health.
   
   Prepares supporting work papers for all cost report entities including but not limited to Wage Index, Expenses, Adjustments, Revenue, Statistics and Resident Rotation Schedules.
   
   Explains any variances from actual to projected settlement amounts.
3. Prepares and Analyzes calculations and supporting schedules for ECU Health entities Contractual Allowances in a timely and accurate manner.
   
   Reviews and analyzes monthly Medicare and Medicaid balance sheet accounts for all entities to ensure for proper reserve levels in a timely and accurate manner.
4. Reads and interprets the Federal Register and other legislation for all third party payers.
   
   Remains updated on changing regulations including but not limited to IP Final Rule, OP Final Rule, Outliers, Rehab Final Rule, Pysch Final Rule and changes relating to Cost Reporting.
5. Prepares documentation for annual audits of cost reports.
   
   Supports ECU Health positions to auditors.
   
   Researches issues unresolved through the audit.
6. Understands rules and regulations surrounding the reporting of Uncompensated Care of ECU Health.
   
   Prepares and Analyzes Schedules to report Uncompensated Care and explains any variances from prior year or quarter.
   
   Ensures all schedules are submitted to North Carolina Medicaid on a timely and accurate basis.
   
   Works with the North Carolina Hospital Association relating to any questions or issues.
7. Performs any special projects as assigned by Manager. Uses knowledge of reimbursement and regulatory issues in performing special projects.

Minimum Requirements

4 year college degree- or higher- in Accounting/Healthcare Admin/Finance, Business or related.

2 to 3 years experience working for CMS, other health care facilities in reimbursement related functions (preferably hospital) or Health Care Division of an Auditing Firm

General Statement

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant's qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.