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Reimbursement Analyst

Work Schedule/Days:  Day / Monday - Friday
Employment Type:  Full-Time
Location:  Support I 
Requisition #:  53366

 

JOB SUMMARY

Uses organizational defined business intelligence solutions and strategies to support the delivery of financial analysis and completes other objectives in support of finance, strategy, business planning, financial operations, performance analytics, cost accounting, budgeting, government affairs, compliance, legal, and other areas.  Proactively supports efforts that ensure delivery of safe patient care and services and promote a safe environment at Children's Healthcare of Atlanta.
 

EDUCATION

• Bachelor’s Degree in Finance, Accounting, Business, or related field.

CERTIFICATION SUMMARY

• Crowe Revenue Cycle Analytics (RCA) – Certified Net Revenue Analyst;
• Certified Public Accountant (CPA); and
• Master’s in Business Administration degree (MBA) in Finance, Accounting, Business or related field.
 

EXPERIENCE*

• 2 years of experience in accounting or finance, preferably in healthcare with experience developing annual budgets and analyzing monthly budget to actual variances.
• 2 years of experience defining, configuring, accessing, querying, and validating financial data using financial software and database systems such as Qlik, Microsoft SQL Server, Access, Excel, Infor, Oracle, or Essbase.

PREFERRED QUALIFICATIONS*

• Relevant experience with:
• Healthcare revenue cycle involving inpatient, outpatient and professional fee billing, third-party reimbursement or managed care contracting at an academic or research oriented medical center;
• Major national managed care and Government (Medicare, Georgia Medicaid) programs and the reimbursement methodologies (DRGs, per diem, discount on charges, capitation) they utilize;
• Preparation of a Medicare/Medicaid cost report;   
• Epic master files and applications; and
• Utilization of Crowe RCA programs to develop balance sheet reserves and analyses;

KNOWLEDGE SKILLS & ABILITIES*

• Demonstrated ability to prioritize and efficiently multi-task, coordinating and managing projects to completion with limited supervision;
• Requires strong analytical skills and the ability to assess big data to identify trends, variances and approaches to remediate or leverage with accuracy and confidentiality. 
• Must be team-oriented, with the ability to collaborate and effectively communicate at the staff, manager, and director level across the organization; and
• Must possess excellent interpersonal, organizational, and communication skills.

JOB RESPONSIBILITIES*

1. Uses system tools to manage data integration, retrieval, processing, validation, and analysis necessary to support timely and accurate governmental, month, and year end reporting, including the calculation of balance sheet reserves, net revenues, and performance relative to budget.
2. Provides reconciliation data to internal and external auditors to ensure compliance with appropriate standards.
3. Conducts assessments of Epic data, payor remittances, and payment for reporting purposes and to optimize coding, billing, and the resolution of payment discrepancies.
4. Participates in project teams that implement and configure reimbursement analytic solutions.
5. Maintains and enhances financial reimbursement reporting to promote productivity, appropriately maximize reimbursement, and accurately track charity and bad debt activities.
6. Prepares financial reports necessary to identify and evaluate impactful trends or changes.
7. Functions as a governmental reimbursement knowledge resource to other departments in finance and across the health system.
8. Follows established policies to ensure appropriate maintenance and use of Children’s Insurance and Transaction master files.

SYSTEM RESPONSIBILITIES*

Safety: Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system.

Compliance: Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Maintains records of compliance activities and reports compliance activities to the Compliance Office.

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.

PHYSICAL DEMANDS*
Ability to lift up to 15 lbs independently not to exceed 50 lbs without assistance
Bending/Stooping - Occasionally (activity or condition exists up to 1/3 of time)
Climbing - Occasionally (activity or condition exists up to 1/3 of time)
Hearing/Speaking - Effective communication with employees, supervisors/managers and staff. Effective communications with patients and visitors, as required.
Lifting - Occasionally (activity or condition exists up to 1/3 of time)
Pushing/Pulling - Occasionally (activity or condition exists up to 1/3 of time)
Sitting - Occasionally (activity or condition exists up to 1/3 of time)
Standing - Occasionally (activity or condition exists up to 1/3 of time)
Walking - Occasionally (activity or condition exists up to 1/3 of time)
WORKING CONDITIONS*
No potential for exposure to blood and body fluids

 

About Us:

Children’s Healthcare of Atlanta has been 100 percent committed to kids for more than 100 years. A not-for-profit organization, Children’s is dedicated to making kids better today and healthier tomorrow.

With 3 hospitals, 20 neighborhood locations and a total of 673 beds, Children’s is the largest healthcare provider for children in Georgia and one of the largest pediatric clinical care providers in the country. Children’s offers access to more than 60 pediatric specialties and programs and is ranked among the top children’s hospitals in the country by U.S. News & World Report.

Children’s has been recognized as a Fortune 100 Best Place to Work, a Best Place for Working Mothers, and as a top employer for diversity and millennials.  We offer a comprehensive compensation and benefit package that supports our mission, vision and values.  We are proud to offer an array of programs and services to our employees that have distinguished us as a best place to work in the country.  Connect to our mission of making kids better today and healthier tomorrow. 

Have questions about the recruitment process?  Check out What to Expect.

Address:  1575 Northeast Expressway, Bldg 1, Atlanta, GA  30329
Function:  Finance/Accounting - Finance