Consultant
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Job Location:
Sacramento, CA - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Job Location:
2200 River Plaza Dr
Sacramento CA 95833
Sacramento CA 95833
Description:
100% Remote
Revised Job Description (Reimbursement Analyst III)
The Reimbursement Analyst III is responsible for preparing reviewing and analyzing complex regulatory reports and cost filings required by Medicare Medicaid/Medi-Cal and other federal and state agencies. This role supports the organizations largest and most complex affiliates and requires demonstrated hands-on experience with HCAI (formerly OSHPD) reporting and Medicare Cost Report preparation.
Core responsibilities include:
Preparing analyzing and validating cost reports supplemental filings and regulatory disclosures in accordance with CMS Medicare Medicaid/Medi-Cal and state agency requirements.
Performing detailed review of Medicare and Medicaid/Medi-Cal audit adjustments; managing the appeals process including preparation of supporting documentation and coordination with CMS/HCFA HCAI and the Department of Health Services.
Serving as a subject matter expert on HCAI annual reporting Medicare/Medicaid reimbursement methodologies program regulations and cost report implications.
Providing financial impact analyses on regulatory changes newly enacted or proposed legislation and reimbursement updates; producing multi-year projections for system and affiliate leaders.
Supporting Managed Care negotiations by supplying reimbursement modeling trending analyses and regulatory insights that influence payer strategy.
Collaborating with affiliate finance teams during contractual reviews and audits and with external auditors or third-party consultants on reimbursement-related evaluations.
Contributing to annual budget development and forecast cycles by supplying government-payer revenue projections grounded in cost report and HCAI data.
Ensuring accuracy timeliness and compliance across all submissions internal workpapers and supporting documentation.
Required Experience:
Direct recent experience preparing and filing HCAI (OSHPD) reports for large or multi-facility healthcare organizations.
Demonstrated experience preparing Medicare Cost Reports (e.g. Form CMS) including worksheets supporting schedules audit follow-up and appeals.
Strong knowledge of CMS reimbursement principles Medi-Cal reimbursement methodologies and regulatory reporting standards.
Advanced analytical skills with the ability to interpret complex regulatory guidance and translate it into financial impact models.
Revised Job Description (Reimbursement Analyst III)
The Reimbursement Analyst III is responsible for preparing reviewing and analyzing complex regulatory reports and cost filings required by Medicare Medicaid/Medi-Cal and other federal and state agencies. This role supports the organizations largest and most complex affiliates and requires demonstrated hands-on experience with HCAI (formerly OSHPD) reporting and Medicare Cost Report preparation.
Core responsibilities include:
Preparing analyzing and validating cost reports supplemental filings and regulatory disclosures in accordance with CMS Medicare Medicaid/Medi-Cal and state agency requirements.
Performing detailed review of Medicare and Medicaid/Medi-Cal audit adjustments; managing the appeals process including preparation of supporting documentation and coordination with CMS/HCFA HCAI and the Department of Health Services.
Serving as a subject matter expert on HCAI annual reporting Medicare/Medicaid reimbursement methodologies program regulations and cost report implications.
Providing financial impact analyses on regulatory changes newly enacted or proposed legislation and reimbursement updates; producing multi-year projections for system and affiliate leaders.
Supporting Managed Care negotiations by supplying reimbursement modeling trending analyses and regulatory insights that influence payer strategy.
Collaborating with affiliate finance teams during contractual reviews and audits and with external auditors or third-party consultants on reimbursement-related evaluations.
Contributing to annual budget development and forecast cycles by supplying government-payer revenue projections grounded in cost report and HCAI data.
Ensuring accuracy timeliness and compliance across all submissions internal workpapers and supporting documentation.
Required Experience:
Direct recent experience preparing and filing HCAI (OSHPD) reports for large or multi-facility healthcare organizations.
Demonstrated experience preparing Medicare Cost Reports (e.g. Form CMS) including worksheets supporting schedules audit follow-up and appeals.
Strong knowledge of CMS reimbursement principles Medi-Cal reimbursement methodologies and regulatory reporting standards.
Advanced analytical skills with the ability to interpret complex regulatory guidance and translate it into financial impact models.
Key Skills
- Sales Experience
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- Hyperion
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- Financial Concepts
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- Peoplesoft
- Oracle
- Financial Management
- Workday
