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   Current UPMC employees must apply in HR Direct

Reimbursement Analyst, Senior

  • Job ID: 204333431
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Western Maryland
  • Department: Finance
  • Location: 12400 Willowbrook Rd, Cumberland MD 21502
  • Union Position: No
  • Salary Range: $24.68 to $42.26 / hour

Description

Conduct and document complex financial analysis projects. Provide functional advice or training to less experienced financial analysts. Take lead and assist with HSCRC related matters.


Responsibilities:

  • Prepare third party cost reports for fiscal year end and acts as support to all other finance departments at  facilities within UPMC.
  • Responsible for Health Services Cost Review Commission (HSCRC) reporting and compliance.
  • Responsible for handling financial and third party government audits.
  • Responsible for a clear and thorough understanding of the cost reporting tools 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.
  • 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.
  • 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
  • Responsible for managing hospital Global Budget Revenue (GBR), make recommendations to maximize reimbursement. 
  • Conduct sensitivity studies and analyses involving healthcare reimbursement impacts and compliance as well as assess and calculate reimbursement impact for new services and making recommendations to management based on these studies.
  • 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.
  • Prepare appeals, or other required information for third party payers
  • 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.
  • Train and assist in the training of Associate and Intermediate Analysts Supervise several projects and related staff at same time.
  • Perform other related third party reimbursement responsibilities as required by manager
  • Performs in accordance with system-wide competencies/behaviors.
  • Performs other duties as assigned.

 

Qualifications

  • Bachelor's degree in accounting/finance or related business field required.
  • MBA preferred.
  • 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

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   Current UPMC employees must apply in HR Direct