Revenue Cycle - Baystate Health

Req#: R21660
Category(s): Finance, Revenue Cycle
Full Time / Part Time: Full-Time
Shift: First

Summary: 
The position supports the preparation of the federal and state cost reports, reserve analysis and related programs and activities for Baystate Administrative Services (BAS), Baystate Medical Center (BMC), Baystate Franklin Medical Center (BFMC), Baystate Wing Hospital (BWH) and Baystate Noble Hospital (BNH).  The position also supports third-party programs and initiatives impacting reimbursement including medical education, wage index, organ acquisition program, reimbursement appeals, regulatory changes, reserves models, settlements, etc.

Job Responsibilities: 

1) State and Federal Cost Reports: coordination, preparation and review for various components of BAS, BMC, BFMC, BWH and BNH state and federal cost reports. Prepare the cost reports in compliance with state and federal rules and regulations.  Ensures that reports are completed timely and substantiated by appropriate documentation.

2) The position support third-party programs and initiatives impacting reimbursement – medical education, wage index, organ acquisition program, reimbursement appeals, regulatory changes, settlements, etc.  Works with internal and external departments as appropriate supporting the programs and initiatives.

3) Third-Party Reserves: preparation and support of third-party reserve analysis for BMC, BFMC, BWH and BNH and ensures reserves are supported by appropriate documentation.  

4) Annual Medicaid Contract: analyzes Medicaid's rate calculations reflected in the proposed Medicaid contract for BMC, BFMC, BWH and BNH to ensure that payment rates are reasonable and based on appropriate documentation.  Preparation and review of the documentation for the annual Medicaid contract.

5) Third-Party Audits: coordination and support of state and federal cost report audits. Acts as a liaison between the auditors and other departments to ensure all requests are addressed in a timely and accurate manner.

6) Reimbursement Appeals: Performs a review of state and federal audit results and recommends adjustments for potential appeal as appropriate.

7) Changes in Reimbursement Regulations: research and analysis of proposed and final changes in reimbursement regulations by Medicare, Medicaid and the Uncompensated Care Pool.

8) Efficiently and effectively responds to audit inquiries and challenges audit results. Effective research, analysis and preparation of third-party reimbursement appeals.

Required Work Experience: 

Bachelor’s Degree – Accounting or Finance

Preferred Work Experience: 

1) 3-5 years of experience in healthcare finance or related fields. 

Skills and Competencies: 

1) Excellent oral and written communication skills

2) Strong interpersonal skills and desire to provide a high level of customer service.

3) Strong computer skills including Excel, Word, and other business applications.

4) Knowledge of state and federal hospital reimbursement and cost report preparation

5)  Ability to work independently, possessing strong independent decision-making skills

You Belong At Baystate

At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.

DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.

Education:

Bachelor of Science: Accounting (Required)

Certifications:

Equal Employment Opportunity Employer

Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.

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