Job: Reimbursement Analyst - San Mateo Medical Center (Departmental Promotional Only)

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Job Description

Overall Job Objective

Job Title:Reimbursement Analyst - San Mateo Medical Center (Departmental Promotional Only)
Closing Date/Time:Thu. 11/02/17 11:59 PM Pacific Time
Salary:$43.02 - $53.78 Hourly
$3,441.60 - $4,302.40 Biweekly
$7,456.80 - $9,321.87 Monthly
$89,481.60 - $111,862.40 Annually
Job Type:Regular
Location:San Mateo County, California
 
At San Mateo Medical Center, we are always seeking ways to enhance the already impressive services we offer. This dedication to excellence is reflected in the exceptional care we provide and the extraordinary professionals who provide it. Here, you will have the chance to develop your talents with a skilled team of people who actively support and encourage each other's success. If you are ready to open new doors for your career, join us today!

We are currently seeking an experienced Reimbursement Analyst to ensure compliance with federal and state government regulations by coordinating and reviewing the annual Medicare and Medicaid cost reports and all supplemental reporting. This responsibility has a direct impact on a significant portion of the hospital's net revenue. This position facilitates communication with appropriate government agencies, consultants, and organization departments to ensure the accuracy, transparency and compliance with State, Medicare and Medicaid regulations; oversees and reviews the preparation of the Department of State Hospitals (DSH) / Uncompensated Care tool ensuring compliance with all related rules and regulations; maintains knowledge of DSH / Uncompensated Care funding regulations and ensures accurate reporting for maximum funding to the hospital; maintains reimbursement model for monthly contractuals; performs analysis of reimbursement as requested by management; maintains National Provider Identifier (NPI) enrollment for all facility providers; orders PSR and CDR as necessary; assists in Federally Qualified Health Center (FQHC) reconciliation, P14 reporting, as well as AB85 and AB915 reports as required; pulls data from databases as needed by management; and keeps workpapers in proper order that they can be auditable by outside agencies.

The ideal candidate will possess the following preferred qualifications:
  • Broad understanding of Medicare and Medicaid (Medi-Cal) regulation and programs demonstrated with a history of working in organizations with revenue sources from Medicare and Medi-Cal in which the incumbent was able to explain the programs to senior management, and prepare budget forecasts and financial statements that accurately represent program activities.
  • Broad understanding of the healthcare revenue cycle, demonstrated by process improvement initiatives that led to quantitative improvements in revenue cycle performance and key performance indicators. 
  • Strong verbal, active listening, and written communication skills.
  • Experience with California Medicaid (Medi-Cal) program state submissions, Waiver Paragraph 14, FQHC, and other supplemental programs.
  • Experience preparing/reviewing Medicare and Medi-Cal cost reports.
  • Experience in presenting program results to executive, financial and operational leaders (including CFOs, executive committees, and boards).
  • Experience in preparing and reviewing account reconciliations, journal entries, and completing a month-end reimbursement package delivered to senior leadership for use in the month-end package.
  • Experience with calculating a monthly contractual adjustment against patient receivables.
  • Intermediate/Advanced Microsoft Excel skills, including the manipulation of large data sets.

NOTE: The eligible list generated from this recruitment may be used to fill future extra-help, term, unclassified, and regular classified vacancies.
 Qualifications:

Knowledge of: Project and/or program management, analytical processes, and report preparation techniques; organizational and management practices as applied to the analysis, evaluation, development, and implementation of programs, policies, and procedures; principles of mathematical and statistical computations; research and reporting methods, techniques, and procedures; modern office practices, methods, and computer equipment and applications related to the work; English usage, grammar, spelling, vocabulary, and punctuation; applicable Federal, State, and local laws, regulatory codes, ordinances, and procedures relevant to assigned area of responsibility; principles and practices of public administration as applied to operational unit and program administration; principles and practices of county management and government; sources of information related to a broad range of county programs, services, and administration; basic principles, practices, and procedures of funding sources and grant funds disbursement; principles and practices of contract administration and evaluation; and public agency budget development and administration, and sound financial management policies and procedures; recent and on-going developments, current literature, and sources of information related to the operations of the assigned division; record keeping principles and procedures; techniques for effectively representing the County in contacts with governmental agencies, community groups, and various business, professional, educational, regulatory, and legislative organizations; and techniques for providing a high level of customer service by effectively dealing with the public, vendors, contractors, and County staff.

Ability to: Assist in the development of goals, objectives, policies, procedures, and work standards for the department; coordinate and oversee programmatic administrative, budgeting, and/or fiscal reporting activities; perform responsible and difficult administrative work involving the use of independent judgment and personal initiative; conduct research on a wide variety of administrative topics including grant funding, contract feasibility, budget and staffing proposals, and operational alternatives; evaluate and develop improvements in operations, procedures, policies, or methods; research, analyze, and evaluate new service delivery methods, procedures, and techniques; prepare clear and concise reports, correspondence, policies, procedures, and other written materials; interpret, apply, explain, and ensure compliance with applicable Federal, State, and local policies, procedures, laws, and regulations; establish and maintain a variety of filing, record keeping, and tracking systems; organize and prioritize a variety of projects and multiple tasks in an effective and timely manner; organize own work, set priorities, and meet critical time deadlines; operate and maintain modern office equipment, including computer equipment and specialized software applications programs; use English effectively to communicate in person, over the telephone, and in writing; establish, maintain, and foster positive and effective working relationships with those contacted in the course of work; plan, organize, and carry out assignments from management staff with minimal direction; plan and conduct effective management, administrative, and operational studies; analyze, interpret, summarize, and present administrative and technical information and data in an effective manner; use tact, initiative, prudence, and independent judgment within general policy and legal guidelines in politically sensitive situations; and effectively represent the department and the County in meetings with governmental agencies, community groups, and various businesses, professional, and regulatory organizations, and in meetings with individuals.

Education and Experience: Any combination of training and experience that would provide the required knowledge, skills, and abilities is qualifying.  A typical way to obtain the required qualifications would be: Equivalent to graduation from an accredited four-year college or university with major coursework in business administration, public administration, or a related field. At least one year of professional administrative experience is typically required at the Associate Management Analyst level, and at least 3 years for the Management Analyst level.

Licenses and Certifications: Depending upon assignment, possession of a valid California Driver's License.
 Application/Examination:
Departmental Promotional Only. Only current San Mateo County employees in the HEALTH SYSTEM with at least six months (1040 hours) of continuous service in a classified regular, probationary, SEIU or AFSCME represented extra-help/term position prior to the final filing date may apply. 
 
Thorough and detailed responses to the supplemental questions must be submitted in addition to the standard San Mateo County employment application. A resume will not be accepted as a substitute for the required employment application and supplemental questionnaire.

The examination process will consist of an application screening (pass/fail) based on the candidate's application and responses to the supplemental questions. Candidates who pass the application screening will be invited to a panel interview (weight: 100%). Depending on the number of applicants, an application appraisal of education and experience may be used in place of other examinations, or further evaluation of work experience may be conducted to group applicants by level of qualification. Applicants who meet the minimum qualifications are not guaranteed advancement through any subsequent phase of the examination. All examinations will be given in San Mateo County, California, and applicants must participate at their own expense.

IMPORTANT: Applications for this position will only be accepted online. If you are currently on the County's website, you may click the "Apply Online" above or below. If you are not on the County's website, please go to http://jobs.smcgov.org to apply.
 
TENTATIVE RECRUITMENT SCHEDULE
Final Filing Date: November 2, 2017, 11:59 PM
Application Screening: Week of November 6, 2017
Panel Interview: TBD

The County of San Mateo does not require job applicants to disclose conviction history information until after the applicant successfully completes all examination phases for the recruitment. All passing applicants will receive instructions by email only from Human Resources staff to complete and submit a conviction history questionnaire online within a specified deadline of two business days. Failure to do so within the time frame will disqualify you from the rest of the process. Please visit http://hr.smcgov.org/conviction-information-applicants-faqs to find out more information about the conviction history questionnaire so that you can prepare accordingly.

Note: Positions in criminal justice agencies currently required by law to pass background checks are exempted from this bill, and applicants may be required to submit conviction information at the time of application.

County of San Mateo is an Equal Opportunity Employer 
 
Analyst: Lillian Lilles (101917) (Management Analyst - D181)

 

 
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