Contributes to the overall financial performance of SSM Health by following policies and procedures, and providing accurate and timely reporting. Ensures best practice by assisting in the development, implementation and completion of governmental reimbursement policies and procedures.
Prepares workpapers for third party cost reports and completes the reports in their entirety in a timely and accurate manner.
Responsible for the completion of Medicare, Medicaid, and Tricare audits & desk reviews. Prepares all documentation and correspondence for the audits & desk reviews as well as perform review of audit adjustments.
Serves as a department resource for reporting needs related to the core work responsibilities. Participates in the standardization process of necessary reports.
Prepares other third party filings as needed.
Prepares the accruals related to third parties for month-end close.
Performs peer review of third party month-end close accruals.
Effectively communicates both verbally and in writing to internal and external parties.
Possesses knowledge of third party reimbursement aspects as it relates to patient level reimbursement and global hospital reimbursement.
Grows in ability to perform regulatory research applicable to government reimbursement.
Performs in a lead capacity to complete analytical and reimbursement projects.
Assists in the activities of IL/MO governmental reimbursement teams, as needed, to provide consistent and accurate financial reporting and information across the IL/MO regions.
Assists in the implementation and maintenance of system-wide and IL/MO workflows and reporting to provide value added financial services related to government reimbursement analysis.
Completes special projects related to governmental reimbursement on ad hoc basis.
Participates in department and team meetings as needed in order to improve net revenue or processes related to governmental reimbursement analytics.
Qualifications Minimum Requirements:
A minimum of 2 years of increasingly responsible experience in governmental reimbursement analysis, principally in health care and preferably in a provider environment.
Experience in non-provider health care setting (insurance, consulting) can be considered in lieu of provider experience.
Bachelor's Degree with concentration in Accounting, Business Administration or related field
SSM Health - System Office –
SSM Health is one of the largest Catholic health systems in the country and is dedicated to quality and compassionate care for anyone in need, regardless of ability to pay. Based in St. Louis, where its System Office is located, SSM Health operates 20 hospitals in Wisconsin, Illinois, Missouri and Oklahoma. We provide care in various settings: outpatient sites, physician offices, a pharmacy benefit company, an insurance plan, hospitals, nursing homes, home care, hospice, telehealth and a technology company.Our Mission: Through our exceptional health care services, we reveal the healing presence of God.
You’ve known us as many names throughout St. Louis, and now, we’re bringing our hospitals, doctors, home care and other services together under one name – SSM Health. With seven hospitals, 350+ physicians, more than 40 physician locations and 12,000 employees, we are part of something bigger and better. We’re connected to a wealth of resources, expertise and advance technology to help you, your fa...mily and our community live long, healthy lives.
We’ve grown and changed a lot over our 143-year history. Our name may be changing but our mission remains the same