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Senior Financial Analyst-Revenue Analysis
Burlington, MassachusettsOrganization Facility: Lahey Hospital and Medical Center Category: General Finance Job ID: JR2750 Date posted: 10/24/2022
When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
Work Shift:Day (United States of America)Job Summary: The Senior Financial Analyst reporting to the Manager of Revenue Analysis this position participates in a wide variety of tasks in support of the institution's Third Party reimbursement efforts and valuation of the Third Party Accounts Receivable. Responsible for the full range of reimbursement functions: cost reporting, audit, interim rate and settlement calculation, net revenue preparation and analysis, net revenue budget preparation and various special projects. Assist in the management of projects and work closely with all members of the Reimbursement work team, including the Director, other Sr. Financial Analysts and Financial Analysts, as well as other Finance personnel.
Keep abreast of Center for Medicare and Medicaid Services and State Regulations where changes and updates may have an impact on the BILH reporting and compiling of required information.
Develop and present to Manager the estimated financial impact of the annual changes in Medicare rules and regulations associated with reimbursement related issues, such as DSH, IME, GME, EHR and Bad Debts in addition to any Quality Measures Reporting (Value Based Purchasing & Readmission Adjustments and Medicare Cost Reporting changes.
Develop and maintain monthly Hospital and Professional Accounts Receivable (AR) financial models; creating the monthly Third Party contractual allowance and reserve for bad debt general ledger journal entries by business unit and reconcile entries to the general ledger to review with Manager.
Compile components of Net Revenue in order to assist management in the review of monthly, annual and budgeted Net Revenue for specific Business Units. Analyze and report monthly casemix information to management with explanations for significant changes versus budget and month to month comparisons.
Assist in the annual preparation and submission of the Medicare and Center for Health Information and Analysis (CHIA) Cost Reports ensuring expense, revenue and statistical information is accurate and subsequent audits.
Responsible for the accumulation and reporting of the Medicare Physician Time Allocation, along with assisting in the development and presentation of educational programs offered to each department. (Lahey Legacy)
Develop, update, explain and maintain quarterly Third Party contractual reserve rates by payer; implementing these rates into the Hospital and Professional AR financial models to estimate and report the net value of AR.
Maintain Medicare Bad Debt and Crossover logs for Medicare Reimbursement. (Lahey Legacy). Create and audit monthly Observation log for Medicare Reimbursement. (Lahey Legacy). Assist in all aspects of gathering and reporting transplant related information to Medicare and develop financial modeling to measure the reimbursement impact of interim Medicare payments versus final settlements.
Provide summary and detailed financial analysis in support of AR contractual and Third Party reserves to auditors.
Submit monthly HSN surcharge report to the state. Assist in the Area Wage Index (AWI) audit, creating documentation related to Salaries & Wages, Contract Labor, Pension and other Wage Related Costs. Create IME reports for submission and invoice verification.
Assist in maintaining Resident and Fellow rotation schedules and demographic information for filing with Medicare.(Lahey Legacy) Work closely with PFS Team on matters that effect reimbursement, including Cash reconciliations, Credit Balance reviews and mapping AR transactions to the GL. Attends meetings as required and participate on various committees as requested.
Bachelor's degree in Accounting, Finance, Business Administration or Health Management. required.
3-5 years related work experience required in Healthcare finance with a focus on Medicare reimbursement and/or payment contract analysis..
Thorough knowledge of third party reimbursement methodologies.
Experience with integrated billing systems (EPIC) or other billing systems.
Excellent comprehension of governmental and payer billing rules and guidelines. Working knowledge of various code sets including: revenue codes, HCPCs, CPT, modifiers, ICD procedure codes, DRG and APC/ APG coding.
Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.
Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.
Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.
Written Communications: Ability to communicate clearly and effectively in written English with internal and external customers.
Oral Communications: Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers.
Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.
Team Work: Ability to interact respectfully with other employees, professional staff and/or external contacts to offer ideas, identify issues, obtain information or deliver services.
Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.
Physical Nature of the Job:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally