Sr Reimbursement Analyst

Summary:
Under the direction of the Manager Reimbursement prepares and assembles all financial and statistical detail (department affiliate and consolidated) to prepare reports required by third party and governmental agencies for Lifespan and affiliate reimbursements. Provides functional supervision of financial analysts on a project basis. Cross trains and participates in budget planning function as appropriate.

 

Responsibilities:
Analyzes financial and statistical data used in the individual affiliate reimbursement reports to determine accuracy consistency from year-to-year and effects on Lifespan reimbursement or final settlements. Plans coordinates monitors and verifies special projects and activities in the financial planning department for reimbursement budgeting forecasting and product line development.



Under the guidance of Financial Planning senior staff understands and participates in the development and implementation of Lifespan and affiliates annual operating budget and capital budget programs. Assists as needed in the timely and accurate preparation of the operating and capital budget.



Coordinates special studies regarding finance and reimbursement of new programs. Serves as project leader of large complex projects providing functional supervision of assigned financial analysts including assigning work scheduling providing guidance and counsel and input for performance evaluation. Trains budget and reimbursement staff in reimbursement function.



Maintains current knowledge of all regulations impacting reimbursement or Lifespan budgeting. Analyzes the impact of new regulations to assure compliance with directives issued by governmental/regulatory agencies or third party payers relating to financial reporting procedures federal wage-price guidelines. Develops data base to meet proposed changes in governmental payment mechanisms.



Verifies and analyzes the rate calculations and final cost settlements submitted by third party payers and governmental agencies for accuracy. Coordinates third party audits and provides assistance to inquiries made during those audits. Assesses impact of third party audit adjustments and informs the Reimbursement Manager.



Prepares and assembles all financial and statistical individual affiliate and consolidated Lifespan reports required by third party and governmental agencies for Lifespan and affiliate reimbursements.



Quantifies estimated rates of reimbursement from all third party payers on a monthly basis. Prepares adjustment of balances in both balance sheet and profit and loss statement to reflect current liabilities to/from third party and government payers.



Participates in administrative staff meetings councils quality improvement teams and other such committees and meetings as required.



Designs and develops educational materials interpreting and communicating results of financial analysis to department heads and senior management. Contributes to development of departmental procedures manual.



Troubleshoots existing or potential problems as soon as identified. Keeps Reimbursement Manager informed regarding issues which impact reimbursement process.



Recommends/develops action plans for areas where formal appeals to third party and governmental payers are warranted. Refines and/or creates methodologies for measuring the impact of changes in reimbursement from third party/government payers. Analyzes pass through payments and advance payments to determine if Lifespan and its affiliates are being underpaid or overpaid.



Develops and maintains working relationship with Lifespan affiliate departments and Lifespan CPA firm as needed to ensure full data exchange.



Maintains quality assurance safety environmental and infection control in accordance with established policies procedures and objectives of the system and affiliates.



Performs other related duties as required.

 

Other information:
BASIC KNOWLEDGE:

Equivalent to a Bachelor�s Degree in accounting finance or related field.



Comprehensive knowledge of accounting procedures technical and professional accounting skills financial and other operations systems to control data collection and reporting activities and understanding of data processing procedures and capabilities.



EXPERIENCE:

Three years progressively responsible experience in health care finance with heavy emphasis on one or more of the following areas: third party reimbursement financial reporting and analysis operating and capital budget forecast and/or product line development.



Comprehensive experience in microcomputer spreadsheet use and database management.



Experience in the use of mainframe computer systems to derive information needed for required financial and reimbursement analyses.



WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

Normal office environment.



SUPERVISORY RESPONSIBILITY:

Functional supervision for up to three (3) full-time equivalent personnel. Supervision is limited to assigning work scheduling providing guidance and counsel and input for performance evaluation.

 

Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status.   Lifespan is a VEVRAA Federal Contractor.

 

Location: Corporate Headquarters USA:RI:Providence

 

Work Type: Full Time

 

Shift: 1

 

Union: Non-Union


Work Schedule M-F 8 AM -4:30 PM