Hours of Work :

40 per week

Days Of Week :

5 days

Work Shift :

Job Description :

Your Job:

The SR REIMBURSEMENT(MEDICARE) ANALYST will assist the Manager of Regulatory Compliance, the Manager of Governmental Accounting, Director of Government Programs and the Vice President/Controller in the reporting of governmental accounting for Methodist Health Systems.

FULLY REMOTE

Your Job Requirements:

• Four-year college accounting degree with demonstrated knowledge of accounting theory, particularly financial systems, financial analysis technique and managerial accounting. Graduate degrees in relevant healthcare/business studies preferred.

• CPA Preferred

• Position requires extensive knowledge of governmental programs ( Medicare and Medicaid).

• Good written and oral communication skills.

• Good interpersonal skills.

• Must be able to manage time in order to meet concurrent deadlines

• Able to maintain and exhibit professionalism

• Excellent communication skills (written and verbal)

• Demonstrated experience using Advanced Excel skills

• Work Experience: 4 years experience in either a hospital or intermediary setting

• Experience using HFS software preferred

• Working knowledge of Hospital Medicare reimbursement areas of Wage Index, Medical Education, Organ Transplant, S-10, Medicare & Medicaid DSH, Charity Care and Bad Debts

Your Job Responsibilities:

• Assist with the preparation of the annual MHS hospital Medicare/Medicaid cost reports and home office cost statement, applying the Medicare/Medicaid regulations and policy requirements of the Federal and State governments for these programs, and the timely filing of these cost reports.

• Assist with any amended reports, reopening reports, and Medicare/Medicaid settlement audits, and wage index reviews.

• Prepare the required Champus reports for all hospitals at completion of the annual hospitals’ Medicare cost reports to obtain payment from Champus for Capital and Medical education costs and file timely.

• Prepare the required Medicaid UC/DSH applications and reconciliations for each hospital according to State of Texas guidelines for timely filing

• Prepare the required Trauma applications for each trauma designated hospital according to the State guidelines for timely filing.

• Prepare departmental components of the annual Community Benefits and AHA Surveys

• And submit to hospital liaison for timely filing.

• Provide the necessary information related to special projects as required for the Director of Reimbursement and Manager of Regulatory Compliance

• Keeping aware of changing Medicare and Medicaid regulations and changes in cost reporting Instructions.

• Additional Job Description

Additional Job Description

Age Specific Care Considerations

This job description is rated the following level for age specific, patient care education and training:

Level I – Incidental Patient Contact

Employee education and training on age specific, patient care considerations for performing these job duties occurs during the “New Hire” general hospital orientation, department specific orientation, annual performance review process, and on-going based on employee and supervisor identification of further training needs. This education incorporates the physical, psychosocial, educational, safety, and related criteria, appropriate to the age of the patients served. All levels annually review the video A Team Focus on Age Specific Care and take a post test. Level’s II and III have additional requirements for assessment and documentation.

Incorporates age specific, patient care considerations when performing their job duties as outlined in this job description. Measurement:

Meets - Consistently incorporates age specific, patient care considerations when performing their job duties. Additional training is not required.

Partially Meets - Sometimes incorporates age specific, patient care considerations when performing their job duties. Direction and additional training to meet the standard are required.

Does Not Meet - Rarely incorporates age specific, patient care considerations when performing their job duties. Supervision, direction and additional training to meet the standard are required.

Analyst Department: MHD Finance

I. Primary Function

Assist the Manager of Regulatory Compliance, the Manager of Governmental Accounting, Director of Government Programs and the Vice President/Controller in the reporting of governmental accounting for Methodist Health Systems.

II. Primary Duties and Measurements

1 Assist with the preparation and review of the financial documentation required for the annual CMS 2552-10 Medicare/Medicaid cost reports for MDMC, MCMC, MMMC, MRMC, SLMC and 287-05 MHS home office (both 6/30 & 9/30) cost report applying the Medicare/Medicaid regulations and policy requirements of the Federal and State governments for these programs and the timely filing of these cost reports.

The complexity of the facilities may include acute care, psychiatric unit, rehabilitation unit, skilled nursing facility, medical education, allied health programs, End Stage Renal Disease, Organ Transplant, Disproportionate Share and subsidiary corporations.

Assist with any annual amended reports, annual reopening reports, and annual Medicare/Medicaid settlement audits for MDMC, MCMC, and MMMC, MRMC, SLMC and MHS home office.

Development objective: Learn the relationship of Medicare Laws, regulations, Program Memorandums, Program Manuals, CMS directives, Intermediary Directives, PRRB case rulings, etc. Obtain/maintain a current knowledge of the Medicare/Medicaid laws/regulations and policy requirements by reading newly published proposed rules, final rules, CMS transmittals, Intermediary newsletters both Medicare and Medicaid, Med- Learn publications, Commerce Clearing House transmittals, Optum OPPS publications, Uniform Billing Editor and other sources as necessary to accomplish. Understand the HFS cost reporting Software/ and continuing updates made by CMS to the cost report including how to use help functions, reading of instructions, interpretation of instructions and using hospital data to file cost report in compliance with instructions.

Develop understanding of reimbursement principles for both Medicare and Medicaid from both retrospective reimbursement and prospective reimbursement standpoint in order to understand the development of RCC and the development of our Medicare and fully defined cost reports which is our main source of fully defined cost ratios.

Measurement – Observation & Feedback

Far Exceeds – Provides accurate data for cost report filing, review data, corrects errors found in data, inputs data into cost report. Works to resolve all issues that come up in the audit of the cost report. Keeps Manager adequately informed of all outstanding issues. Current on all reading materials.

Exceeds – Provides all data and analysis of the data and corrects errors found in data. Resolves majority of issues in the cost report audit.

Meets – Provides data for the cost report and settles majority of the issues related to the audit

Partially Meets – Provides some of the data necessary for the cost report completion

Does Not Meet – Fails to accumulate statistics, provide log allocations, employee logs, and other necessary information for the cost report and fails to get the report filed in a timely manner. Fails to work with the auditors in order to resolve issues related to settling of report.

2 Serve on committees to assure MHS compliance with Medicare/Medicaid laws, regulations and policies. This will include one or more of the following committees: the Payment Differences Committee, Coding Billing Compliance

Development objective: Participate in the research of both reimbursement and compliance issues with Manager of Regulatory compliance. Actively asking questions of both theory and practicality of rules and methodologies of payment systems.

Measurement – Observation & Feedback

Far Exceeds – Attend and actively participate in all assigned committee meetings

Exceeds – Attend and actively participate in the majority of assigned committee meetings Meets – Attend and participate in most of the assigned committee meetings.

Partially Meets – Attends but does not contribute to the assigned committee meetings

Does Not Meet – Fails to attend the assigned committee meetings

3 Provide the necessary information related to special projects as required for the Vice President/Controller, AVP Government Programs, Manager of Government Accounting, and Manager Regulatory Compliance.

Development Objective: Ask questions about projects; understand the full details of projects from beginning to end including reimbursement methodology and impact of issues. Complete understanding of why as well as the impact of the analysis.

Measurement – Observation & Feedback

Far Exceeds – Always provides an excellent, willing attitude and completes projects before the due date.

Exceeds – Frequently provides an excellent, willing attitude and completes projects by the due date.

Partially Meets – Sometimes provides a willing attitude and completes projects by the due date.

Does Not Meet – Rarely provides a willing attitude and rarely completes projects by the due date.

4 Prepare the required Champus reports for all hospitals at completion of the annual hospitals 2552-10 cost reports to obtain payment from Champus for Capital and Medical education costs. File the Champus report in December of each year.

Measurement – Observation & Feedback

Far Exceeds – Prepares the Champus filing within 30 days of the cost report and researches data to find all possible Champus days in the systems

Exceeds – Prepares the Champus filing using the existing systems that we have and completes the proper recording of the position with Champus in the financial records.

Meets – Prepares the Champus filing using existing systems that we have and completes the recording of the position with Champus in the financial records

Partially Meets – Prepares the Champus filing using an estimate.

Does Not Meet – Fails to complete the filing of the Champus report or fails to record in the financial records.

5. Assist CBO and other department managers to resolve Medicare/Medicaid reimbursement, billing, and compliance issues as they arise.

Development objective: Develop an understanding of Reimbursement methodologies (Prospective Payment system) and develop understanding of Medicare and Medicaid billing requirements through reading and researching UB and billing manuals and participating in committees.

Far Exceeds – Always provides an excellent, willing attitude in resolving issues.

Exceeds – Frequently provides an excellent, willing attitude in resolving issues.

Meets – Usually provides a willing attitude in resolving issues.

Partially Meets – Sometimes provides a willing attitude in resolving issues.

Does Not Meet – Rarely provides a willing attitude in resolving issues.

6. Learn duties of the CDM Coordinator to be able to assist and/or back up this staff when in a heavy workload or on vacation, sick leave or PDO.

Development Objective: Obtain understanding of impact of the CDM to the financial success of the organization. Understand the principles of how codes are assigned, the theory and the methodology behind our pricing policies, the responsibilities of the finance department in working with the department directors/ vice presidents in the review of the CDM.

Measurement – Observation & Feedback

Far Exceeds – Provide CDM Coordinator assistance on as needed basis and serve as back up when Revenue Analyst is out of office.

Exceeds – Being available to assist CDM Coordinator.

Meets – Assisting CDM Coordinator in an acceptable time frame.

Partially Meets – Attempting to assist CDM Coordinator with request and providing some but not all the information necessary to complete

Does Not Meet – Failing to help CDM Coordinator with her request

III. Other Duties and Measurements:

Other Duties as Assigned

Measurement – Observation & Feedback

Far Exceeds – Self motivated to do outstanding job ahead of schedule

Exceeds – Self motivated to do an outstanding job and meet all requirements on time

Meets – Meets all requirements of the request on time

Partially Meets –Meets most requirements of the assignment in a reasonable time

Does Not Meet – Fails to meet basic requirements of the assignment

• Job Title Default

Job Title Default

SR REIMBURSEMENT ANALYST

• Restrict to Country

Restrict to Country

(empty)

• Management Level

Management Level

• Individual Contributor

• Job Family

Job Family

• Finance-Compliance

• Job Classifications

Job Classifications

• InclementWeatherNot_Required - Not Required - Not required to report to work (Inclement Weather) (Inclement Weather)

• Non-Clinical - Jobs that do not provide direct patient care. (Patient Care Classification_V2)

• TeamShareLevelLevel_STF - STF - Indicates eligibility for TeamShare bonus program (TeamShare Level) (TeamShare Level)

• USAEEO1_20 - 20 - Professionals (EEO-1-United States of America) (EEO-1-United States of America)

• UserLevelCategory_A - Category A - No patient impact (User Level) (User Level)

• Work Shift Required

Work Shift Required

No

• Public Job

Public Job

No

• Referral Payment Plan

Referral Payment Plan

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Methodist Health System is a faith-based organization with a mission to improve and save lives through compassionate, quality healthcare. For nearly a century, Dallas-based Methodist Health System has been a trusted choice for health and wellness. Named one of the fastest-growing health systems in America by Modern Healthcare , Methodist has a network of 12 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics, among others. Methodist has more than two dozen clinics located throughout the region, renowned teaching programs, innovative research, and a strong commitment to the community. Our reputation as an award-winning employer shows in the distinctions we’ve earned:

• Magnet® designations for Methodist Dallas, Methodist Charlton, Methodist Mansfield, and Methodist Richardson Medical Centers

• 150 Top Places to Work in Healthcare by Becker’s Hospital Review , 2023

• Top 10 Military Friendly® Employer, Gold Designation, 2023

• Top 10 Military Spouse Friendly® Employer, 2023

Methodist Health System is a faith-based organization with a mission to improve and save lives through compassionate, quality healthcare. For nearly a century, Dallas-based Methodist Health System has been a trusted choice for health and wellness. Named one of the fastest-growing health systems in America by Modern Healthcare , Methodist has a network of 12 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics, among others. Methodist has more than two dozen clinics located throughout the region, renowned teaching programs, innovative research, and a strong commitment to the community. Our reputation as an award-winning employer shows in the distinctions we’ve earned:

• Magnet® designations for Methodist Dallas, Methodist Charlton, Methodist Mansfield, and Methodist Richardson Medical Centers

• 150 Top Places to Work in Healthcare by Becker’s Hospital Review , 2023

• Top 10 Military Friendly® Employer, Gold Designation, 2023

• Top 10 Military Spouse Friendly® Employer, 2023

Equal Opportunity Employer

It is the policy of Methodist Health System (MHS) to select, develop, and promote employees based on individual ability and job performance. It has been, and will continue to be, the policy of MHS to provide equal employment opportunity to all people in all aspects of employer-employee relations without discrimination because of race, color, religion, national origin, age, sex, sexual orientation, gender expression, disability, marital status, genetic information or ancestry. This policy affects decisions including, but not limited to, an employee’s compensation, benefits, terms and conditions of employment, opportunities for promotion, training, development, transfer all other privileges of employment. MHS is committed to maintain a working environment free of intimidation, workplace discrimination and harassment. Retaliation or attempted retaliatory behavior that occurs as a result of an employee’s exercise of their rights under this policy or any other statutorily protected right is strictly prohibited and will be grounds for disciplinary action.