The Reimbursement Analyst ensures accurate and compliant reimbursement and case mix transactions in accordance with CMS, state, and contractual requirements. This role is responsible for analyzing proposed reimbursement changes, developing related financial reports, and supporting Medicare cost report preparation. The analyst provides proactive insights to the Director of Reimbursement and the Controller regarding legislative and contractual impacts, programs financial system reports, and supports cost accounting functions across Beacon Health System.

MISSION: We deliver outstanding care, inspire health, and connect with heart.
VALUES: Trust. Respect. Integrity. Compassion.
SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

• Review 835 files to identify and resolve transaction errors.

• Prepare and update monthly contractual allowance analyses for general ledger reporting.

• Analyze the financial impact of proposed reimbursement changes for governmental and commercial payors.

• Program and generate financial reports using system data (PeopleSoft, McKesson, PIC).

• Maintain and update reimbursement tables and software settings for accuracy.

• Configure and update reimbursement contracts in contract management and denial management systems.

• Test updates and new versions of reimbursement-related software to ensure calculation accuracy.

• Prepare statistical and supporting worksheets for Medicare cost reports and wage index filings.

• Gather required data from departments and input it accurately into cost report software.

• Maintain and update cost report files and software systems.

• Support appeals for Medicare and Medicaid cost reports by compiling CMS-compliant documentation.

• Coordinate with third parties to gather labor data for inclusion in the wage index.

• Prepare documentation and workpapers for year-end audits and cost report reviews.

• Answer auditor inquiries and resolve outstanding issues as needed.

• Provide requested materials and information promptly and accurately.

• Develop and generate custom reports for various departments and leadership as needed.

• Respond to ad hoc analysis requests from the Director of Reimbursement and leadership team.

• Provide financial and reimbursement insight to internal stakeholders.

• Design and build reports to analyze accounts receivable and cost vs. reimbursement data.

• Complete additional assignments and special projects as directed.

• Attend and actively participate in departmental meetings.

• Complete mandatory education, annual competencies, and health requirements within defined timeframes.

• Maintain required licenses and certifications in good standing.

• Adhere to all organizational policies, compliance standards, and infection control practices.

• Flexibility to work overtime or alternative shifts as needed.

• Leverage innovation everywhere.

• Cultivate human talent.

• Embrace performance improvement.

• Build greatness through accountability.

• Use information to improve and advance.

• Communicate clearly and continuously.

• Bachelor’s degree in Business Administration, Accounting, Finance, or a related field required.

• Minimum of 3 years of experience in healthcare reimbursement or cost accounting preferred.

• In-depth understanding of Medicare/Medicaid and managed care reimbursement models.

• Advanced knowledge of hospital cost reporting processes and related regulations.

• Proficient in Microsoft Excel; experience with database query and report generation tools.

• Strong analytical and problem-solving skills with attention to detail.

• Excellent written and verbal communication skills with the ability to interact effectively across departments.

• Demonstrated ability to manage multiple priorities in a deadline-driven environment.

• Commitment to Beacon Health System’s mission, values, and performance standards.

• Standard office environment with extended screen time and data work.

• May experience mental fatigue due to detailed analysis work.

• Must possess the physical stamina and mobility to perform essential job duties in an office setting.