Job Description

Job Title: Reimbursement Analyst, Senior
Job ID: 56238677
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility:
Department: Reimbursement
Location: 600 Grant St, Pittsburgh PA 15219

Description

Do you have a background in healthcare finance and reimbursement? UPMC Corporate Finance is hiring a Reimbursement Analyst, Senior to support the Reimbursement department during business hours on Monday through
Friday.

In this role, you will conduct and document complex financial analysis projects and provide functional advice or training to less experienced financial analysts.

Responsibilities:
  • Responsible for handling financial and third party government audits.
  • 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.
  • 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.
  • Perform other related third party reimbursement responsibilities as required by manager
  • Responsible for key Revenue Enhancement initiatives such as the Disproportionate Share, IME, GME, Wage Index, Transplants and Physicians which account for large reimbursement dollars.
  • 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.
  • 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.
  • Supervise several projects and related staff at same time.
  • Prepare appeals, or other required information for third party payers
  • Train and assist in the training of Associate and Intermediate Analysts
  • Prepare third party cost reports for fiscal year end and acts as support to all other reimbursement departments at facilities within UPMC
  • 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

Qualifications

  • Bachelor's degree in accounting/finance or related business field 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/Disability/Veteran

Salary Range: $27.43 to $46.22 / hour

Union Position: No

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