Senior Government Reimbursement Analyst Finance Operations Full Time 8 Hour Days (Exempt) (Non-Union)

This Senior Analyst of Government Reimbursement at Keck Medicine of USC position will support governmental reporting and reimbursement focusing on tasks such as preparing and ensuring compliance with the Medicare Cost Report (MCR) and related Medicaid Cost Reports. Additionally the role involves analyzing payment methods staying current with regulatory changes and supporting cost report preparation and audits. The analyst works collaboratively with finance revenue cycle compliance and clinical teams to maintain proper reimbursement under government program rules. This analyst will coordinate with specialty operational units to keep up with evolving CMS rules and regulations. Some specialty areas include subacute units a certified transplant center a PPS-exempt dedicated cancer hospital delivering BMT and CAR-T therapies. An ideal candidate has experience in PPS and non-PPS reimbursement and a working knowledge of regulatory and compliance requirements therein.

Essential Duties:

• Support the preparation and submission of all Medicare Medi-Cal and Tri-Care cost report filings and amendments on behalf of Keck Medicine of USC home office and its hospitals. Review statistical financial and departmental data for accuracy and compliance with CMS and state regulations escalating discrepancies to the Manager as needed.
• Maintain detailed records of audits data requests auditor sampling responses and appeals. Review audit adjustments for accuracy and update internal reporting processes. Identify potential items for formal Medicare appeal and provide recommendations to the Manager for operational improvements based on audit findings
• Prepare Medicare Cost Report (MCR)-related journal entries and balance sheet reconciliations. Support monthly settlement account estimates related analysis and third-party audits. Generate ad hoc reports to assist with institutional monthly financials. Respond to inquiries and other requests for information escalating complex issues to the Manager as needed.
• Monitor and interpret CMS Medicare and Medicaid reimbursement including proposed and final IPPS and OPPS rules CMS bulletins and related litigation. Summarize key updated and provide concise briefings to the Manager and reimbursement leadership.
• Partner with Finance Revenue Cyle and third-party vendors to collect and validate data for reimbursement-related activities including Medicare bad debt and DSH reporting. Provide analytical support and insights to Manager on reimbursement impacts and compliance.
• Perform other duties as assigned by the Manager to support the reimbursement function and broader departmental goals.

Required Qualifications:

• Req Bachelors Degree in Finance Health Administration Business Accounting or related field.
• Req 3 years hospital reimbursement with a strong focus on government payers including Medicare and Medicaid.
• Req Experience with CMS and state Medicaid hospital payment systems and cost reporting requirements.
• Experience with Medicare and Medicaid reimbursement guidelines including audits and appeals processes.
• Req Strong analytical organizational and communication skills.
• Req Sound business judgment and creative problem-solving attributes.
• Req Experience in GAAP and healthcare financial accounting/reporting consolidation processes.
• Req Demonstrate skills in project planning reviewing and ensuring work is organized and documented.
• Req Working knowledge of Hospital Revenue Cycle (Patient accounting collections denials etc.) and related reporting.
• Proficiency with Microsoft Office (i.e. Excel Word PowerPoint).

Preferred Qualifications:

• Pref Masters degree in Accounting Finance or Health Administration.
  

Required Licenses/Certifications:

• Req Fire Life Safety Training (LA City) If no card upon hire one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only).

USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin protected veteran status disability or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance and with due consideration for patient and student safety. Please refer to theBackground Screening Policy Appendix Dfor specific employment screen implications for the position for which you are applying.

We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at or by email at. Inquiries will be treated as confidential to the extent permitted by law.

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Senior IC