Senior Reimbursement Analyst (Remote - FL, NC, GA & SC Residents Only)
BayCare is seeking an experienced Senior Reimbursement Analyst for a fully remote position. Candidates must reside in Florida, North Carolina, Georgia, or South Carolina, as BayCare is only able to employ team members in these states for this role.
IMPORTANT: Due to the highly specialized nature of this position, only candidates with direct hospital Medicare and Medicaid cost reporting experience will be considered. Applicants without hands-on experience preparing and filing hospital Medicare Cost Reports and supporting reimbursement audits will not be reviewed.
Responsibilities
- The Senior Reimbursement Analyst will work independently within their area of responsibility while developing leadership skills and interacting with all levels of management.
- This position is responsible for government payer reimbursement related to Medicare, Medicaid, and TRICARE/CHAMPUS, including completion of annual Medicare Cost Report filings and audits, Medicaid reimbursement programs, and monitoring government reimbursement regulations and payment methodologies.
- Prepare, review, and file annual hospital Medicare Cost Reports and supporting workpapers.
- Coordinate with Medicare Administrative Contractors (MACs) during audits, settlements, and reimbursement reviews.
- Analyze and interpret CMS, Federal, and State reimbursement regulations and proposed payment system changes.
- Multi-task effectively while providing excellent customer service.
- Develop leadership skills by participating in or leading projects within the Revenue Management department.
- Perform other duties as assigned.
Required Experience & Qualifications
Minimum Qualifications
- Bachelor's degree in Accounting, Finance, Healthcare Administration, Business Administration, or a related field. An unrelated Bachelor's degree may be considered with five years of qualifying reimbursement experience.
- Minimum of five (5) years of progressive healthcare reimbursement experience.
- Minimum of two (2) years of direct experience preparing and filing hospital Medicare Cost Reports, including supporting workpapers, audits, and settlements.
- Experience utilizing HFS software (or equivalent) for Medicare Cost Report preparation and submission.
- Experience working directly with Medicare Administrative Contractors (MACs) during audits and reimbursement reviews.
- Direct experience with hospital Medicare and Medicaid reimbursement methodologies.
Preferred Experience
Candidates should have experience in several of the following areas:
- Medicare Bad Debts
- Disproportionate Share Hospital (DSH)
- Graduate Medical Education (GME)
- Interns and Residents Information System (IRIS)
- Allied Health reporting and reimbursement
- Wage Index Surveys
- Occupational Mix Surveys
- Government reimbursement regulatory analysis
Location & Work Arrangement
Location: Remote (Florida, North Carolina, Georgia, and South Carolina residents only)
Employment Restriction: Candidates must reside and be authorized to work in Florida, North Carolina, Georgia, or South Carolina at the time of hire and throughout employment. BayCare is unable to employ individuals residing outside of these states for this position.
Status: Full Time, Exempt
Shift Hours: 8:00 AM - 5:00 PM
Weekend Work: None
On Call: No
Remote Work: Fully Remote
BayCare Benefits
BayCare offers a competitive total rewards package including:
- Medical, Dental, and Vision Benefits
- Paid Time Off
- Tuition Reimbursement
- 401(k) Match and Additional Annual Contribution
- Annual Performance Appraisals with Merit Increases
- Annual Team Award Bonus
- Community Discounts
- Career Growth Opportunities
- The opportunity to be part of an amazing team and a great place to work
