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 degree or equivalent years of experience

Preferred: Master’s Degree

Experience:

Required: Two to Four years of experience in Federal cost reporting, net / gross revenue support, or decision support analytics in a large healthcare environment, hospital, physician practice, third party payer, Medicare intermediary or accounting/consulting firm. 

Preferred: Experience in Federal cost reporting or auditing, net / gross revenue support, or patient care level decision support analytics in a large healthcare environment, hospital, physician practice, third party payer, Medicare intermediary or accounting/consulting firm. 

Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.

At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.

Core Accountabilities:

Organizational Impact: Executes job responsibilities with the understanding of how output would affect and impact other areas related to own job area/team with occasional guidance. Problem Solving/ Complexity of work: Analyzes moderately complex problems using technical experience and judgment. Breadth of Knowledge: Has expanded knowledge gained through experience within a professional area. Team Interaction: Provides informal guidance and support to team members.

Core Capabilities :

Supporting Colleagues:- Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and gain knowledge in new areas.- Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships.- Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. Delivering Excellent Services:- Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.- Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions.- Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. Ensuring High Quality: - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.- Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure.- Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area.- Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation:- Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches.- Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges.- Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.

Position Qualifications:

Responsibilities:

Certifications:

Work Experience:

Relevant Work Experience

Experience Level:

2 years

Education:

Bachelor's

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 to the principles of equal opportunity and affirmative action. EOE/AA/Women/Minority/Vets/Disabled