Job Summary
The Lead Reimbursement Analyst Lead serves as the primary technical expert for the hospital’s third-party reimbursement functions. This role is responsible for the preparation and submission of complex Medicare and Medicaid cost reports, monitoring regulatory changes, and modeling the financial impact of payer contract updates. This position serves as the bridge between the Finance and Revenue Cycle departments to ensure net revenue integrity.
Job Responsibilities
- Lead the preparation, filing, and audit defense of annual Medicare (CMS-2552) and State Medicaid cost reports.
- Perform monthly contractual allowance calculations and maintain the valuation of accounts receivable (A/R) reserves.
- Monitor federal and state legislative changes (e.g., IPPS/OPPS rulings) and calculate the fiscal impact on the hospital’s bottom line.
- Serve as the lead liaison for Medicare Administrative Contractor (MAC) audits and internal financial statement audits.
- Develop complex financial models to forecast reimbursement trends and support strategic initiatives like new service line pro formas.
- Other duties as assigned.
Education Requirements
- Minimum: Bachelor’s degree in accounting, Finance, or Healthcare Administration.
Experience Requirements
Minimum:
- Five (5) years of experience in healthcare reimbursement or healthcare consulting.
- Advanced Excel skills (macros, Power Query) and experience with cost reporting software (e.g., HFS, HCDS) and EHR systems (Epic).
License/Certification Requirements
- Minimum: None
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Skills Required
- Bachelor's degree in accounting, Finance, or Healthcare Administration
- Five years of experience in healthcare reimbursement or consulting
- Advanced Excel skills (macros, Power Query)
- Experience with cost reporting software (e.g., HFS, HCDS)
- Experience with EHR systems (Epic)
What We Do
Riverview Health is comprised of a full-service, 156-bed hospital in Noblesville, a 16-bed hospital in Westfield, as well as freestanding combined ER and urgent care facilities. Also included are more than 25 primary, immediate and specialty-care facilities in Hamilton County. Riverview Health provides comprehensive inpatient and outpatient services in more than 35 healthcare specialties and has been frequently recognized for its clinical and service excellence, including being named America's 100 Best Hospitals for Orthopedic Surgery by Healthgrades and earning the Healthgrades Outstanding Patient Experience award. For more information on Riverview Health, visit riverview.org.Together, we provide comprehensive inpatient and outpatient services in more than 35 healthcare specialties—and have been frequently recognized for our clinical and service excellence. A wide range of services is provided at our main campus—located at 395 Westfield Rd. in Noblesville—including comprehensive care in heart & vascular, orthopedics, advanced emergency services and a vast array of women's health services. As one of the largest employers in Hamilton County, Riverview Health employs more than 1,400 employees, thereby having a significant impact on the local economy. Riverview Health is owned by the county and does not receive tax dollars for operating expenses.
