Senior Net Revenue & Reimbursement Analyst

This position can be a remote opportunity only for those residing in the following states that Children’s is established in : Nebraska (preferred), Iowa, Idaho, Georgia, Kansas, Missouri, North Carolina, or Tennessee.

At Children’s Nebraska, our mission is to improve the life of every child through exceptional care, advocacy, research and education. As the state’s only full-service pediatric healthcare center, we provide comprehensive, holistic care to our patients and families—from primary and specialty care to behavioral health services and everything in between. Dedicated to a People First culture, we foster an environment with joy, belonging, wellbeing, learning and growth. Turn your passion into purpose and make a difference where it matters most.

A Brief Overview

Subject matter expert on net patient revenue, setting reserves on patient a / r, cost reporting, DSH reporting, and other agency reporting over net patient revenue and reimbursement. Oversees general ledger accounts and ensures accuracy of financial statements by maintaining records of assets, liabilities, profit and loss or other financial activities. Perform variance analysis and interpret results. Analyzes financial data in order to prepare reports, analysis and forecasts. Lead projects and provides training and guidance to other staff members.

Essential Functions

Cost Reporting

Coordinates preparation of all Medicare and Medicaid cost reports.

Analyzes, interprets, and utilizes statistics maintained by the BI team for the cost reporting

Agencies and Surveys

Manages and prepares all DSH and other federal and state surveys

Verifies data for DME / IME payments and works with DHHS as needed

Coordinates with Graduate Medical Education office to ensure compliance with Resident reporting

Continually monitor changes in regulations and payment methodologies

Conducts research on Federal and State regulations / laws

Coordinates regulatory reimbursement audits of the hospital and represents the System

• Responds to proposed audit adjustment

Revenue Cycle Analytics System, Analysis & Net Revenue Accounting

Manages Kodiak Revenue Cycle Analytics (RCA) systems, including, but not limited to, RCA system maintenance, reconciliations between systems, monthly reserve processes, and reporting

Estimates net patient revenue and manages the accounts receivable reserve

Reviews and make necessary changes to EPIC mapping for new accounts, adjustment codes, payment codes, and other transactional mapping data. Ensures all systems are aligned

Records and reconciles gross revenue from patient financial accounting system to accounting systems

Prepares journal entries, account reconciliations, and account analysis to maintain and reconcile the general ledger account balances

Ensures that all expected reimbursement calculations are accurate

Prepares and analyzes reports and effectively communicates findings

Continuously seek efficiencies in processes, make and implement recommendations to improve accounting processes and procedures

Work on special projects as needed

Capable of constructively engaging with various management levels

Maintain working knowledge of GAAP

Assists in maintaining and updating internal controls over financial reporting

Performs and / or assists in technical accounting research and implementation

Work with Revenue Cycle to analyze billing corrections, evaluate payment changes, and assist with various analysis to understand impact to the organization

Work with Director of Managed Care to aid in understanding of reimbursement issues and analyze payor contract changes

Coordinate with various areas in analysis of new departments, impacts of business changes, budgets, and related affects

Assists with consolidated forecasts and budgets, and analyzes trends in revenue, contractual adjustments and other related areas

Education Qualifications

Bachelor's Degree from an accredited college or university in Accounting or Finance Required and

Master's Degree of Accounting or MBA Preferred

Experience Qualifications

Minimum 4 years of experience in net patient revenue accounting and reimbursement functions Required and

Experience with cost reporting Required and

Experience working with financial systems Required

Skills and Abilities

Cost reporting and reimbursement accounting experience required

Ability to communicate complex concepts in simple form to non-finance users to understand the appropriate use and limits of information provided.

High level of systems analysis and problem solving skills necessary in order to develop and implement new procedures and solutions.

Ability to utilize critical thinking skills, do strategic planning and project management.

High sense of purpose and urgency and strong analytical skills.

Ability to work with tight deadlines and identify priorities in a fast-paced, highly visible environment while maintaining attention to detail.

Strong people and interpersonal skills; ability to build relationships; team player.

Fosters creativity, innovation and divergent thinking in self and others.

Ability to effectively implement change.

Demonstrated experience teaching, mentoring and developing skills sets, where appropriate.

Ability to take complex analytical data and synthesize it in reportable and understandable context.

Demonstrated experience teaching, mentoring and developing skills sets, where appropriate.

Strategic and forward-thinking

Flexible and creative

Articulate, collaborative and approachable

Strong written and oral communication skills are required.

GAAP knowledge required

Licenses and Certifications

Children’s is an equal opportunity employer, embracing and valuing the unique strengths and differences of people. We cultivate an inclusive environment of respect and trust where we all belong. We do not discriminate based on race, ethnicity, age, gender identity, religion, disability, veteran status, or any other protected characteristic.

IND123

Requisition ID : 23231