Reimbursement Analyst Lead

Job Summary

Gathers and analyzes financial information in order to perform month-end close processes, prepare cost reports and assist in ad-hoc analysis. Knowledge of facility and physician reimbursement methods will be combined with data analysis and decision-making abilities to determine financial results. Serves as a liaison between other departments providing vital reimbursement information. Works with staff directly to assess skills and provide on-going educational opportunities with a goal of performance improvement. Focus on continuous quality improvements for the department.

Essential Functions

Content expert/educator of annual cost reports in accordance with CMS & State of Michigan regulations. Maintains up-to-date knowledge of Medicare/Medicaid rules and regulations.

Leads work teams across disciplines/departments which are larger in scope in a professional manor. Assumes accountability for the quality and timeliness of the team’s deliverables, ensuring the achievement of team goals and objectives in addition to individual goals and objectives. Serves as a resource to all team members. Trains new employees assigned to the team.

Content expert/educator on reimbursement models. Understand and articulate reimbursement models and standards to internal and external customers. Research issues related to problems arising from reimbursement procedures. Determine root cause and take necessary action to resolve. Ensure effective communication of resolution to appropriate leadership.

On a continuous basis, exercises administrative judgment and assumes responsibility for decisions, consequences, and results. Brings potential solutions to problems or barriers to the achievement of goals and objectives to the attention of management.

Monitor government program websites for timely updates as it relates to medical billing changes, pricing changes which may include ensuring fees are loaded into appropriate fee schedules according to established procedures, etc.

Participates in core work groups to recommend and direct process development. Identifies needs, develops and conducts education, orientation and training, establishes evaluation and effectiveness measurement.

Monitors, develops, and improves job procedures to ensure maximum effectiveness in process and resource time spent on job tasks.

Participates in committees related to the team to provide feedback and ensue that the department is represented in corporate-wide activities and functions.

How Corewell Health cares for you

Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here (https://careers.corewellhealth.org/us/en/benefits-new) .

On-demand pay program powered by Payactiv

Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

Optional identity theft protection, home and auto insurance, pet insurance

Traditional and Roth retirement options with service contribution and match savings

Qualifications

Required

Bachelors Degree Emphasis in health care, business management (or equivalent combination of education and experience).

10 years of relevant experience. Knowledge of Reimbursement, Healthcare Revenue Cycle and/or Finance.

Preferred

10 years of relevant experience Reimbursement methods and procedures, CMS guidelines and cost reports.

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement – to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

Primary Location

SITE – Corewell Health Place – 100 Corewell Drive NW – Grand Rapids

Department Name

Reimbursement

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

8:00 a.m. to 5:00 p.m.

Days Worked

Monday to Friday

Weekend Frequency

Variable weekends

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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.