Note: The job is a remote job and is open to candidates in USA. Emory Healthcare is a leading healthcare provider committed to supporting its employees with valuable resources and benefits. The Senior Financial Government Reimbursement Analyst will serve as a technical subject matter expert responsible for preparing and optimizing governmental cost reports and regulatory filings, while ensuring compliance with CMS and State Medicaid regulations.
Responsibilities
- Prepare Medicare, Medicaid, and Tricare cost reports for assigned entities, managing the full cycle from data collection and workpaper development through filing coordination
- Interpret and apply CMS and State Medicaid regulations to ensure compliant reporting and identify reimbursement optimization opportunities
- Support Wage Index and Occupational Mix survey preparation and filing
- Lead preparation and analysis of complex settlement components including Medicare bad debt, DSH, S-10 uncompensated care, IME/GME, organ acquisition, ESRD, transplant, and other pass-through or supplemental payment programs
- Validate pass-through payments and lump sum adjustments; reconcile interim rates against settled amounts
- Coordinate supporting documentation and audit trails required for desk reviews, audits, and appeals
- Monitor MAC correspondence, settlement notices, and regulatory communications; coordinate responses and required documentation
- Support audit strategy development and defend filed positions through the appeals process
- Prepare monthly third-party settlement model supporting month-end close and reserve reporting
- Support reimbursement forecasting and reserve development through settlement outcome modeling and interim rate change analysis
- Partner with Decision Support, General Accounting, PFS, Case Management, and GME to validate data integrity and ensure accurate reimbursement reporting
- Identify and resolve data discrepancies impacting cost report accuracy or settlement outcomes
- Additional Duties as Assigned
Skills
- Bachelor's degree in Accounting, Finance, or Business
- 5 years minimum experience in accounting/finance with 3 years in reimbursement or cost reporting
- Working knowledge of hospital patient accounting, general ledger, and decision support systems (Epic, Strata, or equivalent)
- Knowledge of pass-through payment structures, lump sum adjustments, and interim rate reconciliation
- Ability to communicate complex reimbursement concepts clearly to finance, clinical, and operational stakeholders
- Experience interfacing with MACs, CMS, and state agencies during audits, desk reviews, and appeals
- Comfortable managing multiple filing deadlines and regulatory timelines simultaneously
- Master's Degree in finance or accounting
- 7 years minimum experience with at least 5 years in reimbursement or cost reporting
- Organ Acquisition, 340B, and IRIS experience preferred
Benefits
- Comprehensive health benefits that start day 1
- Student Loan Repayment Assistance & Reimbursement Programs
- Family-focused benefits
- Wellness incentives
- Ongoing mentorship, *development,* and leadership programs
Company Overview
Company H1B Sponsorship