Senior Reimbursement Analyst - UMMS (Baltimore, MD)

The University of Maryland Medical System Baltimore, MD
Job ID: 61577

Area of Interest: Professionals

Location: Baltimore, MD US

Hours of Work: M-F, 8a-4p

Job Facility: University of Maryland Medical System

Employment Type: Full Time

Shift: DAY

What You Will Do:

Senior Reimbursement Analyst - UMMS (Baltimore, MD)

General Summary

Under limited supervision develops, analyzes, reports and interprets complex financial information to assist management in evaluating and executing the organization's business plans in compliance with the Health Services Cost Review Commission (HSCRC) and Center for Medicare and Medicaid Services (CMS) regulations for multiple facilities. Assists with training Reimbursement Analyst and overseeing routine and special projects

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

Using knowledge of the Health Services Cost Review Commission's (HSCRC) reimbursement policies and regulations, completes financial and statistical modeling to produce required monthly, quarterly and annual reports ensuring all possible reimbursement opportunities are captured. Reports include: Annual Filing, Wage & Salary Survey, Community Benefit Report and Residents & Interns Survey.

Prepares all required supporting schedules in accordance with the Center for Medicare and Medicaid Services (CMS) to complete the Medicare Cost Report for assigned facilities.

Prepares routine internal reports for management review to ensure accurate revenue booking and compliance are achieved for assigned facilities. These reports include but are not limited to Volume & Price Report, Unit Rate Compliance Report, 8th and 10th Day Month-End Close Reports.

Analyzes unit rate and charge-per-case compliance to ensure assigned facilities maintain compliance in accordance with HSCRC and CMS regulations. Recommends and ensures implementation of necessary price changes.

Identifies reimbursement reporting opportunities designed to improve operational efficiency and reimbursement under current HSCRC policies and regulations. Assists managers and directors in developing protocols and documenting procedures.

Communicates with departments within Shared Services and at assigned facilities in order to proactively identify opportunities for data integrity improvement.

Acts as coordinator for gathering data and reviewing required analysis at the request of audit staff for annual financial statement audit, quarterly agreed-upon procedures and HSCRC special audit.

Using fundamental knowledge of UMMS accounting, decision support and charge capture for multiple facilities, performs complex and intricate financial modeling for the development of internal reports/analysis that assists management with making operational decisions.

Works closely with UMMS decision support and financial planning personnel to develop revenue projections and estimated rates for the development of annual revenue budgets for assigned facilities. Maintains and develops budget models that accurately calculate and incorporate all HSCRC rate factors and methodologies.

Represents department on special internal and/or external committees or task force to develop procedures and reporting methodologies as it relates to regulatory compliance and reimbursement. Presents and interprets relevant financial and statistical information on behalf of the organization.

Researches complex regulatory and reimbursement issues and provides analysis/summaries for management team.

Provides Reimbursement staff with on-going training. Reviews Reimbursement Analyst performance while communicating and enforcing standards of performance and productivity.

What You Need to Be Successful:

Education and Experience

Bachelor's degree in Economics, Accounting or a related field with principals or practices in analysis and financial reporting.

Four (4) years progressively responsible financial planning, financial analysis, budgeting, managed care or accounting experience, or the educational equivalent. Advanced degree in Economics, Accounting, Finance, Health Policy or a related field may be substituted for years of experience.

3. Two (2) years of HSCRC report preparation including but not limited to Annual Report of Revenue, Expenses and Volumes; Wage & Salary Survey; and monthly HSCRC compliance reporting.

Knowledge, Skills and Abilities

1. Proficient knowledge of HSCRC policies, methodologies, and reporting requirements. Experience with Medicare Cost reporting. Acute care auditing/consulting may be substituted for HSCRC report preparation.

2. Ability to build expertise by studying HSCRC regulations and policies. Attends and participates in internal trainings and other professional educational programs as it relates to CMS and HSCRC policy.

3. Demonstrates ability to apply knowledge of Medicare and HSCRC regulations to train, interpret, and present information to internal and external customers.

4. Ability to judge the level of confidentiality of information / activities involved in job and exhibit integrity in use of dissemination of such information.

5. Advanced knowledge of spreadsheets (i.e., Lotus, Microsoft Excel), databases (i.e., Microsoft Access), word processing programs (i.e., Microsoft Word), graphic/specialty and other finance- related software programs.

6. Highly effective verbal and written communication skills are necessary in dealing with a variety of healthcare and finance professionals including senior management staff.

7. Ability to develop complex financial models and analyze multiple sources of data impacting the reimbursement of UMMS facilities.

8. Ability to use logic and reasoning to identify strengths and weaknesses of alternative solutions, conclusions or approaches to problems.

9. Proficient understanding of how the data and operational systems should work and the impact on reporting, regulatory compliance and reimbursement.

10. Ability to combine multiple sources of information to form general relationships and conclusions.

11. Ability to work effectively in a matrix work environment and manage multiple deadline driven projects.

12. Ability to work in a stressful environment.

We are an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.