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Analyst, Reimbursement III

Bloomington, MNOnsiteFull Time$42–$63 /hrPosted 2 months agoVisa sponsorship available

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Required skills

  • cost reports
  • net revenue valuation
  • accounts receivable valuation
  • payor settlement liabilities
  • decision support system
  • reimbursement modeling
  • patient services
  • government regulatory issues
  • general accounting
  • Medicare

Nice to have

  • skilled nursing facility
  • home health agency
  • home office

Role summary

HealthPartners is seeking a Reimbursement Analyst III to prepare hospital and facility cost reports, support external audits for revenue and receivable valuations, and manage decision support system reimbursement modeling. This role involves analyzing net patient revenue, updating settlement liabilities, evaluating accounts receivable, and providing audit documentation. The analyst will also prepare Medicare cost reports, assist with audits and appeals, model reimbursement for Medicare & Medicaid, and analyze regulatory changes. Additional duties include filing annual Department of Health reports, grant applications, and trade association surveys, as well as preparing annual revenue budgets and mid-year forecasts.

HealthPartners is hiring a Reimbursement Analyst III. 

The Reimbursement Analyst III is responsible for the preparation of hospital, hospice, home health agency, home office and skilled nursing facility cost reports, support for annual external audit related to net revenue valuation, net accounts receivable valuation, and pay or settlement liabilities. This position is also responsible for maintaining decision support system reimbursement modeling and auditing of same to ensure that calculated net revenues reasonably match actual payments. Other special analysis related to patient services, government regulatory issues and general accounting as assigned.

MAJOR JOB DUTIES AND TASKS:

Percentage

Of Time:

1. Evaluation of Net Patient Services Revenue and Accounts Receivable 10%

  1. Monthly analysis and valuation of net patient services revenue

  1. Interim updating of Medicare and third party settlement liabilities

  1. Quarterly evaluation of net patient accounts receivable and adjustments as

required

  1. External Audit resource for documentation needed to audit net patient 

revenue and net patient accounts receivable valuation


2. Medicare Cost Report Preparation and Audit Support  50%

  1. Prepare cost reports for Regions and HealthPartners affiliates

  1. Assist the Reimbursement Manager with Medicare audit support as needed

  1. Assist the Reimbursement Manager with the preparation of Medicare appeal
  2. Documentation and position paper preparation as needed

3. Decision Support System Modeling and Analysis 10%

  1. Modeling of Net Revenue Reimbursement for Medicare & Medicaid

  1. Auditing of Decision Support System reimbursement and costing

  1. Analysis of regulatory and program changes using decision support system


4. Other Regulatory Reporting 20%

  1. Filing of annual Department of Health Hospital Annual Report based on existing 

State of Minnesota regulations

  1. Filing of annual Department of Health Medical Education and Research Cost 

grant application based on existing State of Minnesota regulations

  1. Completion of trade association survey data related to patient services revenue

and statistical data available from regular analytical records
5. Preparation of annual net patient services revenue budget and associated other operating revenues 10%

  1. Preparation of assumption driven inpatient and outpatient gross revenue, 

contractual allowance and net patient services revenue budget based on

historical data and business volume changes as communicated by management

direction

  1. Prepare analysis for mid year forecasting of net revenue


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