Advanced Knowledge of reimbursement methodologies, as well as a broad knowledge of medical, billing and hospital terminology to provide analytical expertise to projects related to managed care reimbursement models for hospitals, physician and ancillary services
Establish and maintain payment methodology scenarios for all payers within the decision support systems to estimate net patient revenue.
Complete audits of decision support information and reconcile to revenues in Financial Statements.
Prepare ad hoc reports and analysis related to reimbursement scenarios and other revenue analysis.
Perform impact analysis of estimated financial risks associated with reimbursement methodology changes, pro formas and business strategies.
Perform analysis utilizing advanced functions of analytical and modeling tools to validate contract performance to identify discrepancies and report, recommend and monitor settlement results.
Provide analytical support to Revenue Management leadership related to both Governmental and Managed Care reimbursement activity.
Develop recommendations and coordinate implementation of maintenance, changes and improvements to revenue-related systems.
Evaluate revenue processes to identify opportunities for improvements and efficiencies.
Identify data and system needs related to revenue accounting, analysis, and reporting.
Act as central resource of Net Revenue-related information for all users of financial information.
Facilitate understanding of reimbursement methods and underwriting techniques, through formal and informal education to internal staff and key contacts
Prepare schedules and analysis which support completion of various external and internal requests for revenue and/or margin & profitability information.
- Bachelor's Degree in Accounting, Finance, Business Administration.
- 4 -6 years and/or equivalent experience in accounting or finance related role
- 3 years relevant modeling experience and analytical experience in healthcare; familiarity with contract modeling software.
- 7-10 years of experience; health care setting preferred.
- CMA / CPA