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Medicare\Medicaid Cost Reporting Analyst

PURPOSE AND SCOPE:
Supports FMCNA's mission, vision, core values and customer service philosophy.
Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements.
Supports FMCNA's mission to maintain a high standard of internal controls associated with FMS accounting/financial operations, while ensuring adherence to division and corporate financial policies and procedures and state and federal regulations.
Acts as primary liaison with CMS contractor auditors for Medicare Bad Debt audits and desk reviews.
Provides training and feedback to Billing Group personnel regarding issues with Medicare Bad Debt write-offs identified during CMS Contractor audits.
Validates all year-end reporting on Medicare Bad Debt as part of overall preparation of annual Medicare Cost Reports.
Coordinates preparation and submission of quarterly Credit Balance reports to Medicare.
DUTIES / ACTIVITIES:
CUSTOMER SERVICE:
Responsible for driving the FMS culture through values and customer service standards.
Accountable for outstanding customer service to all external and internal customers.
Develops and maintains effective relationships through effective and timely communication.
Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner.
PRINCIPAL RESPONSIBILITIES AND DUTIES Responsible for providing audit support documentation related to bad debt inquiries.
Coordinate external government Medicare Contractor audits of Cost Reports as point person for all audit activity- respond to PBC requests, minimize dis-allowed claims through research and review of Medicare auditor tests and calculations.
Assist with annual Medicare Cost Report preparation.
Balances and verifies amount claimed for Medicare Bad Debt write-offs and recoveries.
Prepare and submit Quarterly Credit Balances reports to Medicare or to any other appropriate agency as required Collaborates with appropriate Division personnel to investigate, address and resolve anomalies pertaining to cost reports and bad debt write-offs.
Administers the storage and archiving of cost reports, lists of participating providers, and other department documents related to the annual cost reporting cycles.
Provides training and feedback to division level billing group personnel on issues related to accuracy and timing of Medicare Bad Debt write-offs.
Receives and reviews all notices of program reimbursement from the field and maintains appropriate storage routines of all correspondence.
Generates and maintains listings to record Medicare audits, and tracks audits that remain in progress.
Track documentation requests to ensure requests have been fulfilled.
Reports to manager the status of audits and any documentation deficiencies.
Verifies accuracy of account balances related to cost recovery payments at division level.
Coordinates with other divisions as needed to ensure that re-aligned facilities are properly and timely addressed.
Completes special projects and other duties as assigned by management.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians.
The position requires travel between assigned facilities and various locations within the community.
Travel to Regional, Divisional and Corporate meetings may be required.
EDUCATION Bachelor's Degree; either major in Accounting, or equivalent required.
CPA, CIA, or other professional financial certification preferred.
EXPERIENCE AND REQUIRED SKILLS Experience 3-5 years' experience in audit; FI or MC experience preferred.
Knowledge of Medicare and Medicaid cost report requirements is preferred.
Attention to detail is required.
Proficient PC skills including Word, Excel and Power Point required.
Knowledge of Medicare regulations and/or medical billing/reimbursement preferred.
Special Skills Strong technical skills associated with GAAP, auditing and internal controls.
Strong written and oral presentations skills.
Time management and project management skills a plus.
EO/AA Employer:
Minorities/Females/Veterans/Disabled

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