Lead Financial Analyst

at  RWJBarnabas Health

JOB OVERVIEW:

The Reimbursement Lead Financial Analyst is responsible for the preparation of Medicare and Medicaid cost reports using data from company general ledger and patient accounting systems. Communicating with Hospital personnel and Corporate Hospital Finance staff to capture and collect data relating to Medicare and Medicaid cost reporting, and financial audits, and State surveys. Organizing and assembling cost report work papers into appropriate storage and retrieval mechanisms, maintaining cost report software and updates to newly released versions, assisting with the preparation of quarterly Periodic Interim Payment reports, performing PS&R (Medicare) reconciliations using Medicare payment summaries. The Reimbursement Lead Financial Analyst will focus on monitoring payment related State and federal regulations that impact claim adjudication and will ensure provider reimbursement is maintained and accurate at all times. The Reimbursement Lead Financial Analyst will be responsible for monitoring/forecasting payments going in and out and knowing when those payments should be made.

QUALIFICATIONS:

Required:

• BS degree in Accounting, Finance or Business Administration is required
• Minimum of 4 years of experience interpreting Medicare and Medicaid payment regulations, ensuring optimization of revenue and completing Medicare and Medicaid cost reports.
• Expert level of knowledge of Medicare and Medicaid regulation and payment rules is essential.
• The ability to interpret Medicare and Medicaid payment regulations and develop and implement processes ensuring hospitals are reimbursed for all programs and services is required.
• Educated on and follows Generally Accepted Accounting Principles (GAAP);
• Experience working with Medicare/Medicaid and commercial claims coding rules/ regulatory requirements Medical claims auditing for payment accurate and/or contracting
• Strong analytical skills Expert Excel user i.e., working with large data sets, pivot tables, and v-look up
• Requires excellent organizational and task-prioritization skills.
• Strong oral and written communication skills.

ESSENTIAL FUNCTIONS:

• Prepares Medicare and Medicaid cost reports and supporting forms/schedules as required.
• Verifies State and federal issued reimbursement rates.
• Investigates and responds to desk audit reviews/questions/adjustments.
• Investigates and responds to audit adjustments.
• Maintains working knowledge of various Medicaid state regulations and Medicare federal regulations.
• Assists in orientation, training and development of new Financial Analysts as needed.
• Supervises Financial and Senior Financial Analyst(s) in completion of certain projects when assigned by senior management.
• Assists in Reimbursement Department projects not listed above.
• Assists in special projects as needed.
• Other work duties as assigned.

OTHER DUTIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!