Medicare Cost Reporting and Reimbursement Regulatory Analyst (Financial Analyst) - 100% REMOTE

Discover Vanderbilt University Medical Center:  Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and where your diversity of culture, thinking, learning, and leading is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Organization:

Finance Reimb/Acct

Job Summary:

The primary purpose of the financial analyst is to support and perform analyses of financial matters related to reimbursement, net revenue and Medicare cost reporting. The work performed by this role encompasses reporting on both technical and professional services. This position requires ability to translate Federal/State rules and regulations into practice, excellent analytical, financial, and cost accounting skills, broad information system user skills, good judgment and decision-making abilities, excellent interpersonal and communication skills and the ability to function under pressure due to time constrains and audits.

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KEY RESPONSIBILITIES
Supports and conducts qualitative and quantitative analyses including financial analysis, cost/benefits analysis, market analysis, revenue / reimbursement analysis related to net revenue and reimbursement issues.  Work is performed at a variety of levels including patient, program, payor, clinic, disease-site, patient care center, and others.  Requires familiarity with clinical operations, billing, and coding.  Research analysis outcomes at the patient detail level using available which span both technical and professional services.

Compiles and analyzes data from various internal/external databases and provides information to management in support of decision making. Consolidates, summarizes, or transforms transaction data to support analytical reporting and trend analysis. 

Supports preparation and detail analytics associated with Medicare reimbursement including:

• Preparation of the annual cost reports and the supporting documentation
• Testing of new techniques of cost finding.
• Preparation of Wage Index, Contract Labor, Bad Debt, GME, PS&R, space, and other analyses.

Provides supporting documentation needed to defend the hospital’s position upon cost report audit, reviews audit adjustments for reopening opportunities, and appeals disputed issues from the annual Medicare Cost Report and compiles appropriate supporting documentation. Reviews Intermediary workpapers and assists in translating audit results into impact analysis. Thoroughly documents work for consistency and reproducibility. Supports annual and month end financial close processes including compiling support for audits when necessary. Assists with analytics in support of budgeting and forecasting net revenues and third party reimbursement. 

Performs other special projects as assigned.

Required Skills:

• Experience with gross and net revenue modeling or budgeting and forecasting
• Understanding various processes associated with revenue cycle in a complex business environment.
• Experience with business intelligence tools and Standard Query Language (SQL).
• Experience with Microsoft office programs
• Ability to gather relevant information systematically and breakdown problems into simple components and make sound decisions
• Ability to analyze and translate Federal and State regulations impacting reimbursement
• Experience with gross and net revenue modeling or budgeting and forecasting
• Excellent presentation and communication skills

Preferred Skills:

• Knowledge of third-party contracting concepts
• Experience with Medicare cost report filing
• Experience with patient care level data analysis and reporting.
• Familiarity with an Electronic Medical Record
• Working knowledge of  hospital or professional patient accounting systems
• Familiarity with charge description master
• Knowledge of ICD CM and coding

Minimum Requirements:

Education and Certifications

Required: Bachelor’s