Management & Supervision
Full Time
8 Hour Shift
Rancho Mirage, CA 92270
Job #
  • Job Objective: A brief overview of the position.
    • Responsible for defining, developing and maintaining an on-going inhouse management system of databases, financial models and spreadsheets to support financial management reporting for monthly contractual reserve analysis, annual OSHPD reporting and Medicare/ Medi-Cal cost reporting. Provides support in the areas of reimbursement and revenue maximization, including preparation of the Medicare/Medi-Cal cost reporting and annual OSHPD reporting, charge and revenue code maintenance as it relates to reimbursement, contractual reserve analysis/accounting, and third party audit. Maintains Medicare/Medi-Cal Bad Debt Logs. Performs studies and makes recommendations that utilize financial analysis and reimbursement/revenue analytical skills.
  • Reports to
    • Controller
  • Supervises
    • N/A
  • Ages of Patients
    • N/A
  • Blood Borne Pathogens
    • Minimal/ No Potential
  • Qualifications
    • Education
      • Required: BA in Business, Finance, Accounting or equivalent
    • Licensure/Certification
      • N/A
    • Experience
      • Required: Minimum of 2 years financial analysis or reimbursement experience in healthcare setting, 1 year of capitation financial analysis and HCm system experience preferred.
  • Essential Responsibilities
    • Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
    • Act as a consulting team member on reimbursement and revenue recovery projects, including policy, procedure and system changes necessary to maximize reimbursement
    • Stay current with state and federal reporting regulations and reimbursement changes. Assists with updates to Medical Records, Grouper, and to the hospital chargemaster as it relates to DRG rates, UB92/CPT coding changes and billing requirements. Support the maintenance of daily adds, changes and deletes to the hospital chargemaster (Revenue and Stats) for UB92/CPT coding or new product line setup.
    • Prepare work papers to support the annual OSHPD reporting and Medicare/Medi-Cal cost reporting. Develop and maintain the necessary database models which analyze, forecast and evaluate financial utilization data to support government reporting, monthly contractual reserve analysis/third party audit, and capitation revenue management.
    • Support audits for third party reserves, and Medicare/Medi-Cal cost report audits.
    • Provide technical and administrative support to management and staff including design and development of spreadsheets, graphics, and financial database models that utilize financial analysis and revenue/reimbursement analytical skills. Performs bank statement reconciliation and backs up daily general ledger cash reconciliation.
    • Maintain monthly Medicare/Medi-Cal Bad Debt Logs.
    • Utilize appropriate project controls to ensure that project objectives are met in a timely and cost effective manner.
    • The above statement reflects the general duties considered necessary to describe the principle functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the job.

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