Senior Reimbursement Analyst

Perform third-party reimbursement services. Communicates with personnel of various departments. Confidential information: Has access to patient data through third-party payment logs and, Epic, salary information through Payroll, as needed. Works independently with limited supervision; uses independent judgement and discretion in making decisions within guidelines defined by Carilion leadership. Work is used in support/preparation of the monthly contractual allowance closings, filing of  third-party cost reports and as supporting information in decision making by management.  Develops estimates and reports that are significant to Carilion’s financial statement accuracy and financial performance. Must provide own transportation and travel to other Carilion work sites.

• Prepare reimbursement templates; analyze and reconcile third-party accounts; prepare monthly closing and analyses; prepare information for General Accounting to enable management to make informed decisions. Design, review and maintain process for evaluation and estimation of contractual discounts and third-party liabilities. Approach all estimates with an eye towards continious process improvement; document approaches and rationale recognizing the criticality of accuracy.
• Gather data from multiple sources, conduct data analysis as required to complete Medicare and Medicaid cost reports and other required filings; prepare the cost reports.
• Review/prepare budgeted contractual adjustments.
• Work with third-party auditors and coordinate obtaining information requested by the auditors.
• Conduct reimbursement research.
• Provide third-party reimbursement support including providing information and analysis to Vice President- Accounting Services, Financial Advisory staff, Service Line managers, and personnel from other departments, as required.
• Conduct special projects.
• Provide information and analysis for tax filings.
• Assist in training new reimbursement staff and financial advisory staff in third-party reimbursement.
• Serve as information resource for Reimbursement Analyst and Financial Analyst.