Reimbursement Analyst, Government Programs

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  • Oakland, CA
  • Finance
  • Reimbursement
  • Full Time - Day
  • Business Professional & IT
  • Req #: 25243-16555
  • Posted: February 4, 2020
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SUMMARY:  Responsible for a number of complex and higher level assignments. This position is expected to function somewhat independently with a medium amount of oversight while performing reimbursement related tasks  and projects, many with externally imposed deadlines and significant financial exposure. This position is intended to assist the Director of Reimbursement and Senior Reimbursement Analyst in improving revenue   and reimbursement streams; revenue accounting, resource preservation; appeals and cost reporting. May act  in the capacity of a project lead or coordinator for assigned reimbursement projects. Performs related duties   as required.
DUTIES & ESSENTIAL JOB FUNCTIONS:  NOTE: The following are the duties performed by employees in this classification.  However, employees may perform other related duties at an equivalent level.  Not all duties listed are necessarily performed by each individual in the classification.

1. Accurately prepares and assembles financial and statistical reports required by governmental and third party agencies consistent with current regulations and contract terms.
2. Analyzes and models financial and statistical data used in third party reimbursement.

3. Analyzes patient and payor accounts receivables and related third  party settlements.

4. Assists in the preparation of Medicare and Medi-Cost cost reports, and OSPHD reports.

5. Assists in the preparation of reports and spreadsheets required under the California Medi-Cal Waiver program.

6. Assists in the support of work paper development and tasks related to external financial audits.

7. Develops and maintains revenue modeling systems.

8. Projects and reconciles periodic Medicare interim  (PIP) payments.

9. Provides other project and administrative support to the Manager, Reimbursement as needed.

10. Reconciles accounts receivable subsidiary ledgers/systems to the general ledger, including, but not limited to, government patient admission logs.

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education: Bachelor's Degree with major coursework in business, accounting, economics or a field related to the work.

Minimum Experience: One year relevant experience preferred.

Preferred Licenses/Certifications: Any HFMA or related professional organization certificates are desirable.

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