What are the responsibilities and job description for the Reimbursement Analyst position at Kaiser Permanente?
Job Summary:
The Reimbursement Analyst will be responsible for preparing the monthly contractual allowances for all payors and prepare analyses for month-end close meetings. The Reimbursement Analyst will be assisting in the annual contractual budget and forecasting processes. The Reimbursement Analyst will maintain and work with auditors in validating information as reported on the financial statements. The analyst should have a proficient knowledge of federal and state rules and regulations.
Essential Responsibilities:
- Prepares the calculation of Accounts Receivable and reserves for all payors including the timely submission of the monthly journal entry.
- Prepares all contractual allowance percentages from zero balance account data.
- Prepares trend reports and analyses of charges, payments and contractual allowance and explain significant variances.
- Assists in the annual contractual budget and forecasting process.
- Assists with the annual financial audit.
- Reviews payor contract rates and ensures timely update of contract provisions in the EPIC contract management system.
- Perform reviews of over and under payments based on expected reimbursement to amounts allowed by payors.
- Researches root-cause for issues arising from the monthly AR valuation.
- Performs interim-month reviews of patient accounts and evaluate impact on month-end AR valuation.
- Work with Patient Financial Services to determine impact of billing operations to AR valuation.
- Work with revenue cycle staff to acquire data regarding payment, denials and other related data as it relates to AR valuation.
- Prepares logs and data needed for the preparation of Medicare and Medicare cost reports and interim reviews.
- Prepares Medicaid logs that match the Medicaid cost report in the required format in a timely manner.
- Prepares various financial analyses as requested by management.
- Maintains current working knowledge of Medicare, Medicaid and other regulations.
- Prepares and analyzes financial data for opportunities.
- Attends staff meetings, designation mandatory meetings, and completes annual competency testing.
Qualifications:
Basic Qualifications:
Experience
- Minimum five (5) years of experience related to charge description master (CDM) or Revenue Cycle.
Education
- Bachelors degree OR four (4) years of experience in a directly related field
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- N/A
Additional Requirements:
- Excellent written and communication skills.
- Ability to write, present, and explain recommended materials in a clear, concise and organized format
- Proficient in Word and Excel applications.
- Proven analytical skills.
- Experience in the use of CPT, HCPCS, and Revenue Codes
- Knowledge of medical terminology, coding rules, state and federal compliance rules and regulations.
- Working knowledge of Epic.
Preferred Qualifications:
- Epic Certification
- Working knowledge of Access, and other necessary computer applications.
- Ability to function in multiple capacities.
- Strong analytical, problem solving, listening, and resolution skills.
- Ability to compose reports and recommendations.
- Strong interpersonal and communications skills.
- Detail oriented, problem solving, listening and resolution skills.
- Strong time management skills and ability to meet deadlines.
- Demonstrated work attendance.
- Flexibility to complete immediate projects as needed.
