Working as an Accountant within Patient Financial Services here at Memorial you will be under the direction of the Director of Third Party Reimbursement, the Reimbursement Accountant provides ongoing support required to administer the third-party reimbursement mechanisms for Memorial Medical Center and its affiliate hospitals within the Health System.  Correlate understanding of government-party payor regulations and requirements with working skills to prepare monthly contractual allowance entries, assist with technical analysis of third-party reimbursement issues such as Medicare, managed care and the residency programs with S.I.U. School of Medicine.  Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values.

Education:

• Bachelor Degree in Business Administration in Accounting, Finance, or Economics required.

Experience:

• One year of experience in healthcare reimbursement and /or related field preferred. Such experience must have provided a basic knowledge of third party payment principles and regulations including exposure to managed care reimbursement.

Other Knowledge/Skills/Abilities:

• Understanding of third party reimbursement cost reports desirable but not required.
• Exposure to General Ledger, Billing/Accounts Receivable, Millennium Power Chart, or Decision Support is desired but not required.
• Must be able to display proficient skills in spreadsheet applications such as Microsoft Excel.
• Excellent verbal/written communication skills are required. A working knowledge with various web-based internet applications is preferred but not required.
• Must possess a valid IL driver’s license and must be deemed as an acceptable driver in accordance with the MHS Fleet Safety Policy (five year MVR will be required).

1. Assist the Senior Reimbursement Accountant with monthly contractual analysis such as Medicare, Medicaid, Blue Cross, and various managed care contracts. The Reimbursement Accountant would be expected to perform assigned functions of the monthly analysis with little supervision in order to meet designated closing deadlines.  The dollar volume of financial statement write offs typically exceed $1.7 billion per year.

1. Assist the Senior Reimbursement Accountant and Director by compiling the medical resident FTE information from New Innovations Work Duty Monitoring System. This information is converted into FTE analysis by which this FTE information assists the medical center with critical medical education reimbursement.  Direct and Indirect Medical Education Reimbursement typically exceed $19 million in reimbursement per year.

1. Assist the Senior Reimbursement Accountant with preparation of the System and Medical Center Medicare and State Cost reports each fiscal year when the need is necessary.

1. Assist the Senior Reimbursement Accountant with organizing and compiling the medical center medical director time records each month. This hourly time record information is maintained and monitored through the medical center’s web-based contract record system called Medi-tract.  The information obtained from the medical director time information is required for annual Medicare cost report submissions and critical Wage Index cost report submission each year.

1. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values:

• • SAFETY: Prevent Harm - I put safety first in everything I do.  I take action to ensure the safety of others.
  • COURTESY: Serve Others - I treat others with dignity and respect.  I project a professional image and positive attitude.
  • QUALITY: Improve Outcomes - I continually advance my knowledge, skills and performance.  I work with others to achieve superior results.
  • EFFICIENCY: Reduce Waste - I use time and resources wisely.  I prevent defects and delays.

1. Assist the Director and outside vendor needs for review of Post Transfer Medicare DRG payments. This process involves compiling and documenting various discharge disposition code information in the Millennium Power Chart medical record system.  This task will have interaction with various departments such as Case Management, Health Information Management, Patient Financial Services, and Memorial Home Services on a regular basis.  This task will involve the ability to monitor payment changes in the Florida Shared System due to re-billings by Patient Financial Services.

1. Assist the Director with annual budget net revenue analysis for Medicare, Medicaid, and Other Managed Care payer categories.

1. Assist with the compilation and documentation of annual Hospital Questionnaire surveys from such agencies such as the Association of American Medical Colleges (COTH), the Illinois Department of Public Health, and the American Hospital Association.

1. Assist with the departmental analysis of Rehabilitation CMG quarterly data, Product Line information by Payer category, and Tricare patient day information for reimbursement analysis.

1. Assist the Director in compiling the weekly Blue Cross UPP computer file to determine the correct payment for Blue Cross with necessary journal entry to General Accounting.

1. Monitor important Managed Care payer groups such as the reconciliation of the UPP reserve analysis, reconciliation of the Health Alliance employee health claims payments, and monitoring of annual Managed Care reimbursement contract term changes.

1. Show consistent support for the Guest Relations Program and the Statement of Values.

1. Perform other duties as assigned in support of Third Party Reimbursement or Senior Management in Finance.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job.  Incumbents may be requested to perform tasks other than those specifically presented in this description.