Summary:
Under the direction of the Manager of Reimbursement prepares and analyzes all financial and statistical detail (department affiliate and consolidated) required to complete cost reports as required by third party and governmental agencies; prepares and analyzes net revenue schedules and entries for month end close; develops the net revenue budget and participates in all third party reimbursement audits for Brown University Health affiliates.
Responsibilities:
Analyzes financial and statistical data used in the individual affiliate reimbursement reports to determine accuracy consistency from year-to-year and effects on Brown University Health reimbursement or final settlements. Plans coordinates monitors and verifies special projects and activities in the financial planning department for reimbursement budgeting forecasting and product line development.
Understands and participates in the development and implementation of Brown University Health and affiliates annual net revenue operating budget.
Coordinates special studies regarding finance and reimbursement of new programs. Prices out government reimbursement payments for new or expanded clinical programs.
Maintains current knowledge of all regulations impacting reimbursement or Brown University Health budgeting. Analyzes the impact of new regulations to assure compliance with directives issued by governmental/regulatory agencies or third party payers relating to financial reporting procedures federal wage-price guidelines.
Verifies and analyzes the rate calculations and final cost settlements submitted by third party payers and governmental agencies for accuracy. Coordinates third party audits and provides assistance to inquiries made during those audits.Assesses impact of third party audit adjustments and informs the Reimbursement Manager.
Prepares and assembles all financial and statistical individual affiliate and consolidated Brown University Health reports required by third party and governmental agencies for Brown University Health and affiliate reimbursements.
Quantifies estimated rates of reimbursement from all third party payers on a monthly basis. Prepares adjustment of balances in both balance sheet and profit and loss statement to reflect current liabilities to/from third party and government payers.
Participates in administrative staff meetings councils quality improvement teams and other such committees and meetings as required.
Designs and develops educational materials interpreting and communicating results of financial analysis to department heads and senior management. Contributes to development of departmental procedures manual.
Troubleshoots existing or potential problems as soon as identified. Keeps Reimbursement Manager informed regarding issues which impact reimbursement process.
Recommends/develops action plans for areas where formal appeals to third party and governmental payers are warranted. Refines and/or creates methodologies for measuring the impact of changes in reimbursement from third party/government payers. Analyzes pass through payments and advance payments to determine if Brown University Health and its affiliates are being underpaid or overpaid.
Develops and maintains working relationship with Brown University Health affiliate departments and Brown University Health CPA firm as needed to ensure full data exchange.
Maintains quality assurance safety environmental and infection control in accordance with established policies procedures and objectives of the system and affiliates.
Performs other related duties as required.
Other information:
BASIC KNOWLEDGE:
Equivalent to a Bachelor�s Degree in accounting finance or related field.
Comprehensive knowledge of accounting procedures technical and professional accounting skills financial and other operations systems to control data collection and reporting activities and understanding of data processing procedures and capabilities.
EXPERIENCE:
Three to five years progressively responsible experience in health care finance with heavy emphasis on one or more of the following areas:third party reimbursement financial reporting and analysis net revenue operating budget forecast and/or product line development.
Comprehensive experience in the use of Excel based financial models and database management.
Experience in the use of EPIC EPSI Peoplesoft or similar integrated financial systems to derive information needed for required financial and reimbursement analyses.
WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:
Normal office environment.
INDEPENDENT ACTION:
Incumbent functions independently within a broad scope of department policies and practices; generally refers specific problems to supervisor only where clarification of departmental policies and procedures may be required.
Brown University Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Brown University Health is a VEVRAA Federal Contractor.
Location: Brown University Health Corporate Services USA:RI:Providence
Work Type: Full Time
Shift: Shift 1
Union: Non-Union