Senior Financial Analyst- Reimbursement
Beth Israel Lahey Health · United States · $83K–$112K/yr
Hospitals and Health Care · 1,001-5,000 employees
About the role
The Senior Financial Analyst manages third-party reimbursement functions, including cost reporting, audit support, and net revenue analysis. They are responsible for developing financial models, ensuring regulatory compliance, and reconciling accounts receivable to the general ledger.
What they look for
Requirements
The role requires expertise in Medicare and state reimbursement regulations, financial modeling, and reporting. Candidates must be capable of managing complex projects and collaborating with finance teams to ensure accurate financial data and audit readiness.
Benefits
Full description
When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
The Senior Reimbursement Reporting Analyst, reporting to the Director, Cost Reporting & Reimbursement, participates in a wide variety of tasks in support of the institution's Third-Party reimbursement efforts and valuation of the Third-Party Accounts Receivable. Responsible for the full range of reimbursement functions: cost reporting, audit, interim rate and settlement calculation, net revenue preparation and analysis, net revenue budget preparation and various special projects. Assist in the management of projects and work closely with all members of the Reimbursement work team, including the Director, other Sr. Financial Analysts and Financial Analysts, as well as other Finance personnel.
Job Description:
Additional Job Description
Keep abreast of Center for Medicare and Medicaid Services and State Regulations where changes and updates may have an impact on the BILH reporting and compiling of required information.
Develop and present to Manager the estimated financial impact of the annual changes in Medicare rules and regulations associated with reimbursement related issues, such as DSH, IME, GME, EHR and Bad Debts in addition to any Quality Measures Reporting (Value Based Purchasing & Readmission Adjustments and Medicare Cost Reporting changes.
Develop and maintain monthly Hospital and Professional Accounts Receivable (AR) financial models; creating the monthly Third-Party contractual allowance and reserve for bad debt general ledger journal entries by business unit and reconcile entries to the general ledger to review with Manager.
Compile components of Net Revenue in order to assist management in the review of monthly, annual and budgeted Net Revenue for specific Business Units.
Analyze and report monthly case mix information to management with explanations for significant changes versus budget and month to month comparisons.
Assist in the annual preparation and submission of the Medicare and Center for Health Information and Analysis (CHIA) Cost Reports ensuring expense, revenue and statistical information is accurate and subsequent audits.
Responsible for the accumulation and reporting of the Medicare Physician Time Allocation, along with assisting in the development and presentation of educational programs offered to each department.
Develop, update, explain and maintain quarterly Third-Party contractual reserve rates by payer; implementing these rates into the Hospital and Professional AR financial models to estimate and report the net value of AR.
Maintain Medicare Bad Debt and Crossover logs for Medicare Reimbursement.
Create and audit monthly Observation log for Medicare Reimbursement.
Assist in all aspects of gathering and reporting transplant related information to Medicare and develop financial modeling to measure the reimbursement impact of interim Medicare payments versus final settlements.
Provide summary and detailed financial analysis in support of AR contractual and Third-Party reserves to auditors.
Submit monthly HSN surcharge report to the state. Assist in the Area Wage Index (AWI) audit, creating documentation related to Salaries & Wages, Contract Labor, Pension and other Wage Related Costs. Create IME reports for submission and invoice verification.
Assist in maintaining Resident and Fellow rotation schedules and demographic information for filing with Medicare.
Work closely with PFS Team on matters that effect reimbursement, including Cash reconciliations, Credit Balance reviews and mapping AR transactions to the GL.
Attends meetings as required and participate on various committees as requested.
Pay Range:
$83,200.00 USD - $111,904.00 USD
The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.
As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.
More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.
Equal Opportunity Employer/Veterans/Disabled
