INTEGRIS HEALTH Oklahoma’s largest not-for-profit health system has a great opportunity for a Reimbursement Specialist Sr. In this position, you’ll work remotely with our Financial Reporting team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering with people to live healthier lives speaks to you, apply today, and learn more about our increased compensation plans and recently enhanced benefits package for all eligible caregivers such as front-loaded PTO, 100% INTEGRIS Health paid short-term disability, increased retirement match, and paid family leave. We invite you to join us as we strive to be The Most Trusted Partner for Health.
The Senior Regulatory Reporting Analyst will be responsible for preparation of hospital cost reports, net revenue and AR analysis and reporting, reimbursement impact analysis and data mining for the Reimbursement Department. The Senior Analyst will join a Reimbursement team that supports the entire health system. They may work on reimbursement matters and reporting for individual hospital(s) or more than one.
Responsibilities
(Core Functions - 75% of time spent) The Reimbursement Specialist Senior responsibilities include but are not limited to, the following:
- Responsible for collecting, recording and reviewing all documentation required by CMS for submission in several key areas: Organ Acquisition, Bad Debts and DSH
- Responsible for collecting, recording, reviewing, and reconciling all Physician Time Studies
- Actively participate in and contribute to ad hoc revenue analysis projects
- Preparation and submission of accurate and timely Medicare and other third-party cost reports in compliance with CMS regulations
- Manages and coordinates Medicare cost report audits including wage index, EHR and other special audits including review of proposed audit adjustments
- Assists with the identification of Medicare issues that should be appealed or reopened
- Reviews the reasonableness and accuracy of interim reimbursement rates and special payments from Medicare and third-party payors and follow up with the MAC as appropriate
- Prepares monthly contractual allowances for Medicare and Medicaid
- Prepares monthly cost report reserves schedules
- Prepares and submits annual Medicaid DSH surveys and participates in the annual Medicaid DSH audits and year end Cost Report filings
- Monitors proposed and final changes in Medicare regulations and reimbursement and provide updated schedules for the reimbursement department Reports to the System Reimbursement Director
- This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information. Strength (Lift/Carry/Push/Pull) : Sedentary (exerting up to 10 pounds of force occasionally) Standing/Walking: Occasionally; activity exists up to 1/3 of the time Keyboarding/Dexterity: Frequently; activity exists 1/3 to 2/3 of the time Talking (Must be able to effectively communicate verbally): Yes Seeing: Yes Hearing: Yes Color Acuity (Must be able to distinguish and identify colors): No No inherent job hazards. Heavy work volume and tight deadlines as well as high degree of accuracy required. May experience frequent interruptions (telephone and walk in), exposed to the anger of unsatisfied customers (physicians and public), and involved in multiple projects at any given time. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
Qualifications
REQUIRED QUALIFICATIONS
EXPERIENCE:
- 3-5 years of experience in hospital third party reimbursement
EDUCATION:
- Bachelors degree in Accounting/Finance or business-related field or five years equivalent work experience
PREFERRED QUALIFICATIONS
EXPERIENCE:
- Experience with the Medicare Administrative Contractor is highly preferred
- Experience with PeopleSoft and Epic is highly preferred
Company
To our patients, that means we will partner to provide unprecedented access to quality and compassionate health care. To you, it means some of the state's best career and development opportunities. With INTEGRIS Health, you will have a genuine chance to make a difference in your life and your career.
INTEGRIS Health is the state's largest Oklahoma-owned health system with hospitals, rehabilitation centers, physician clinics, mental health facilities and home health agencies throughout much of the state.