Job Description

Job Title: Reimbursement Analyst, Sr.
Job ID: 689811
Status: Casual
Regular/Temporary: Limited
Hours:
Shift: Day Job
Facility:
Department: Reimbursement
Location: 600 Grant St, Pittsburgh PA 15219

Description

Purpose:
Conduct and document complex financial analysis projects. Provide functional advice or training to less experienced financial analysts.

Responsibilities:
  • Analyze and review all third payer CRA accounts, Report any discrepancies or inaccuracies to appropriate management personnel in order to maintain the integrity of the financial statements.
  • Analyze and review government third party interim payment rates and prepare data submission to third party payers to update interim payment rates and report interim rate updates to corporate and facility departments.
  • Conduct sensitivity studies and analyses involving healthcare reimbursement impacts and compliance as well as assess and calculate reimbursement potential for new provider services and making recommendations to management based on these studies.
  • Maintain an ongoing understanding of government regulations as they relate to reimbursement issues, analyze the impact of these regulations and apply these to the documentation that is maintained for the preparation of the third party cost reports.
  • Perform other related third party reimbursement responsibilities as required by manager
  • Prepare appeals, or other required information for third party payers
  • Prepare third party cost reports for fiscal year end and acts as support to all other reimbursement departments at facilities within UPMC
  • Responsible for a clear and thorough understanding of the cost report software to ensure its efficient and accurate use. Also maintain backup files of all old and new software versions to ensure our ability to restore return and revise prior cost reports due to audit or appeal circumstances.
  • Responsible for handling financial and third party government audits.
  • Responsible for key Revenue Enhancement initiatives such as the Disproportionate Share, IME, GME, Wage Index, Transplants and Physicians which account for large reimbursement dollars.
  • Review, analyze and document all third party audit adjustments, recommending either acceptance or rejection of those adjustments, and if necessary, preparing appeals and position papers related to those audit adjustments
  • Supervise several projects and related staff at same time.
  • Train and assist in the training of Associate and Intermediate Analysts

Qualifications

  • Bachelors degree in accounting/finance or related business field is required.
  • Four years job related experience in the reimbursement field or health care finance field preferred.

Licensure, Certifications, and Clearances:
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $26.64 to $44.88

Union Position: No

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