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Senior Financial Analyst Payment Systems

Job ID 144412 Date posted 05/19/2018

Position Summary: Reporting to the Director of Government Reporting and Analysis this position participates in a wide variety of tasks in support of the institutions Third Party reimbursement efforts and valuation of the Third Party Accounts Receivable.

Essential Duties & Responsibilities including but not limited to:
- Keep abreast of Center for Medicare and Medicaid Services and State Regulations where changes and updates may have an impact on the LHS reporting and compiling of required information.
- Develop and present to Director the estimated financial impact of the annual changes in Medicare rules and regulations associated with reimbursement related issues, such as IME, GME, EHR and Bad Debts in addition to any Quality Measures Reporting (Value Based Purchasing & Readmission Adjustments and Medicare Cost Reporting changes.
- Develop and maintain monthly Hospital and Professional Accounts Receivable (AR) financial models; creating the monthly Third Party contractual allowance and reserve for bad debt general ledger journal entries by business unit and reconcile entries to the general ledger to review with Director.
- Create, maintain and distribute the monthly AR summary worksheets (current year, prior year) utilized during the review of financial statements.
- Assist in the annual preparation and submission of the Medicare and Center for Health Information and Analysis (CHIA) Cost Reports ensuring expense, revenue and statistical information is accurate.
- Responsible for the accumulation and reporting of the Medicare Physician Time Allocation, along with assisting in the development and presentation of educational programs offered to each department.
- Develop, update, explain and maintain quarterly Third Party contractual reserve rates by payer; implementing these rates into the Hospital and Professional AR financial models to estimate and report the net value of AR.
- Maintain Medicare Bad Debt and Crossover logs for Medicare Reimbursement.
- Create and audit monthly Observation log for Medicare Reimbursement.
- Assist in all aspects of gathering and reporting transplant related information to Medicare and develop financial modeling to measure the reimbursement impact of interim Medicare payments versus final settlements.
- Provide summary and detailed financial analysis in support of AR contractual and Third Party reserves to auditors.
- Assist in the State and Federal Cost report audits, providing supporting documentation for all expenses reported, cost based reimbursement aspects (Transplant) as well as IME, GME, EHR and Bad Debt.
- Assist in the Area Wage Index (AWI) audit, creating documentation related to Salaries & Wages, Contract Labor, Pension and other Wage Related Costs.
- Compile and maintain required documentation for filing the Periodic Medicare Occupational Mix Adjustment Survey (MOMA)
- Assist in maintaining Resident and Fellow rotation schedules and demographic information for filing with Medicare.

Organizational Requirements:
- Incorporates Lahey Health Guiding Principles into daily activities.
- Complies with all Lahey Health Policies.
- Complies with behavioral expectations of the department and Lahey Health.
- Maintains courteous and effective interactions with colleagues and patients.
- Demonstrates an understanding of the job description, performance expectations, and competency assessment.
- Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.
- Participates in departmental and/or interdepartmental quality improvement activities.
- Participates in and successfully completes Mandatory Education.
- Performs all other duties as needed or directed to meet the needs of the department.

- Attends meetings as required and participate on various committees as requested.
- This position may have other ongoing and periodic projects or responsibilities in addition to those listed above.


Education: Bachelors' degree, preferably in Accounting, Finance, Business Administration or Health Management.

Licensure, Certification, Registration: None Required

Skills, Knowledge & Abilities: Excellent analytical, verbal and written communication

Excellent comprehension of governmental and payer billing rules and guidelines.

Working knowledge of various code sets including: revenue codes, HCPCs, CPT, modifiers, ICD procedure codes, DRG and APC/ APG coding

Thorough knowledge of Microsoft office software (Excel & Access) and computer systems.

Individual with Dynamic personality who is self motivated

3-5 years in healthcare finance with a focus on reimbursement and/or payment contract analysis

Thorough knowledge of third party reimbursement methodologies

Experience with integrated billing systems (EPIC) or other billing systems such as Meditech or IDX



About Lahey Health

The Lahey Model of Care?right care, right time, right place?is exactly what patients, providers and payers need and deserve. Identifying and delivering on this convergence of interests has positioned Lahey Health for further growth. Our model ensures care is highly coordinated and locally delivered, with lower costs and exceptional quality.

Lahey Health is a robust, regional system including a teaching hospital, community hospitals, primary care providers, specialists, behavioral and home health services, skilled nursing and rehabilitation facilities, and senior care resources throughout northeastern Massachusetts and southern New Hampshire. The system has a global presence with programs in Canada, Jordan and Bermuda.

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