Oneida, NY
Full-time


Oneida Health is an independent 101-bed acute care community hospital and a 160-bed extended-care facility (ECF) and short-term rehab facility licensed by the State of New York and operated by Oneida Health Systems, Inc., a New York not-for-profit corporation. The hospital is Joint Commission accredited.

We are proud to share that we have recognized for several national awards based upon safety of care as well as the patient experience of care. The first recognition is provided by The Leapfrog Group, a nationally recognized non-profit organization who reviews 30 patient quality and safety measures and assigns a letter grade to over 2,600 hospitals nationally based upon outcomes. The fall 2019 letter grade for OHC is a “B.”, our eighth consecutive “A” or “B”. Our hospital was also awarded 4 Stars for Patient Experience.

The second recognition is for the Healthgrades Patient Safety Excellence Award. Our hospital is among the top 10% nationally for patient safety and is 1 of only 16 hospitals in New York to receive this award for 2019. The third recognition is for the Healthgrades Outstanding Patient Experience Award. Our hospital is among the top 10% nationally for patient experience and is 1 of only 8 hospitals in New York to receive this award for 2019…with Oneida Health as the only hospital in New York State to receive both awards for 2019! We are also very proud of our CMS 4-Star overall rating for patient experience and CMS 5-Star for quality measures.

www.oneidahealthcare.org

POSITION SUMMARY

The Reimbursement Analyst provides third party reimbursement support. The analyst is required to understand third party reimbursement systems and policies, including governmental and non-governmental payors. The analyst is responsible for understanding billing, CPT coding application, accounting and performing regulatory financial impact analyses. Responsibilities include performing third party contractual analysis, formulating contract payment strategies and assist in the preparation of federal and state cost reporting. The position is vital for reporting requirements and oversight of payment integrity. The analyst must stay current with emerging reimbursement changes, makes recommendations on payer contracts and implement process improvements and revenue enhancement/maximization projects. The position reports to the Controller.

ESSENTIAL POSITION FUNCTIONS

  • Accumulate revenue, cost and statistical data for the Medicare and Medicaid Institutional Cost Report
  • Coordinate resolution of intermediary and state agency audit requests, including obtaining audit documentation from other departments and communicating status to Controller
  • Maintains and reviews files concerning regulations from Medicare, Medicaid, Federal Register, State Regulatory initiatives and other healthcare related matters that have an impact on the organizations reimbursement
  • Verifies third party payment rate changes are occurring and ensures changes are incorporated into the budget
  • Review all third party contracts and make recommendations/comments in conjunction with CFO
  • Design, review and maintain process for evaluation and estimation of contractual discounts and third-party liabilities.
  • Analyze and reconcile third-party accounts
  • Prepare monthly closing and analyses
  • Providers revenue, cost, statistical, and reimbursement impact data in preparation of third party rate appeals
  • Coordinates the Medicare/Medicaid ICR and DSH filing and audit
  • Works with the intermediary or third party auditors on federal cost report re-openers and appeals within the set deadlines
  • Serves as primary liaison for aspects of the HCRA Surcharge process
  • Responsible for filing monthly Statewide Pools and Cash Receipt Assessments
  • Other duties as assigned by Controller or CFO

QUALIFICATIONS:

  • Education: BS in Accounting, Finance or related field
  • Experience: 3-4 years of healthcare experience preferred

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