Reimbursement Analyst
State of Nebraska

Job Info

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Hiring Agency:
Health & Human Services - Agency 25

Location:
Lincoln, NE

Hiring Rate:
$26.327

Job Posting:
JR2024-00011320 Reimbursement Analyst (Open)

Applications No Longer Accepted On (If no date is displayed, job is posted as open until closed):
11-25-2024

Job Description:
The Nebraska Department of Health and Human Services, Division of Medicaid and Long-Term Care, is seeking a Reimbursement Analyst to join our team. In this role, you will determine reimbursement rates for all facilities participating in the Nebraska Medicaid reimbursement program and oversee or conduct annual desk audits of these facilities. If you have a keen eye for detail and experience in financial analysis, this could be the perfect opportunity for you!

Examples of Work

Responsibilities of the Reimbursement Analyst include:

• Maintains various Medicaid fee schedules (examples include FQHC, RHC, Assisted Living, Hospice, Tribal, Mental Health Substance Abuse, Transportation, Personal Assistance Services, Specialized Services) by ensuring fee schedules are updated timely and accurately
• Ensures fee schedules reflect appropriate rates based on legislative appropriations, applicable/as needed rate setting research and applicable content for rate development and maintenance
• Provides rate setting component support for all hospital types and reimbursement methods; provides critical access hospital rebasing settlement and rate rebasing support
• Provides Direct/Indirect/Supplemental Graduate Medical Education (DME/IME/GME), Disproportionate Share Hospital (DSH), Poison Control and Hospital Directed Payment audit/calculation/payment supports.
• Supports the annual DSH audit and DSH survey process by working with an established vendor and team to ensure the DSH audit is completed according to established Federal standards and that the DSH survey process is conversely completed per Federal standards.
• Issues various payments (including but not limited to) DSH, DME/IME/GME, Poison Control, DHHS contractor) through the Department's OnBase system.
• Participates in various meetings and workgroups to support the Rates and Reimbursement team assigned Reimbursement Analyst functions.
• Use of data warehouse to extrapolate needed data.
• Interpret (primarily Medicare) cost report data for purposes of various calculations.

Requirements / Qualifications:

Minimum Qualifications: Bachelor's degree in accounting or business administration with emphasis in accounting or auditing OR equivalent experience. In addition, this position requires experience in auditing long-term care providers participating in the Nebraska Medicaid reimbursement program and in interpreting and applying the Nebraska Medicaid reimbursement regulations.

Legal Requirements: Positions in this classification are subject to Title 42, Nebraska Administrative Code, Chapter 1 - Minimum Standards for Government Employees Identified as Auditors. The basic requirement is a Bachelor's degree in business administration or the equivalent, with at least 24 semester hours of accounting or auditing. Any combination of education with a concentration in accounting and auditing experience acceptable to the Auditor of Public Accounts, may be substituted for the educational requirements in Section 002.01.

Preferred Qualifications: Coursework/training or experience in Accounting/Finance/Management-related activities (2 years minimum) including use of a personal computer, various associated software programs (i.e. Enterprise 1, OnBase, Oracle products), and office equipment. Experience/proficiency using Excel, Word, Outlook (2 years minimum). Experience in interpreting and applying State or Federal regulations (2 years minimum). Experience in rate analysis/setting. Experience conducting robust research/analysis for decision making. Experience interpreting cost reports (including Medicare) to extrapolate data for various calculations.

Knowledge, skills, abilities

Coursework/training or experience in a Finance/Medical claims billing/Business Management activities. Coursework training/experience including use of a personal computer with various applicable financial software/internal system products for job functions (i.e. Enterprise 1, OnBase, Oracle products); proficiency using Microsoft Office products, including Excel, Word and Outlook. Must have good Excel skills and be able to apply/compute various filtering, computations and display of data. Knowledge of Excel pivot tables is helpful. Ability to complete work activities timely and efficiently. Good written and oral communication/customer service/relationship skills. Strong organizational, time management and problem-solving/critical thinking skills; adaptability to various tasks and ability to accurately follow Standard Operating Procedures and apply on-the-job training activities to practice is also important. Regular, predictable attendance is necessary.


Benefits

We offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life. Your paycheck is just part of your total compensation.

Check out all that the State of Nebraska has to offer! Benefit eligibility may vary by position, agency and employment status. For more information on benefits, please visit: https://statejobs.nebraska.gov/index.html#benefits

Equal Opportunity Statement

The State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.

Current employees of the State of Nebraska should NOT apply on this external career. Instead go to Workday and access the Jobs Hub - Internal Apply app from your home landing page.

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