This Senior Analyst of Government Reimbursement at Keck Medicine of USC position will support governmental reporting and reimbursement, focusing on tasks such as preparing and ensuring compliance with the Medicare Cost Report (MCR) and related Medicaid Cost Reports. Additionally, the role involves analyzing payment methods, staying current with regulatory changes, and supporting cost report preparation and audits. The analyst works collaboratively with finance, revenue cycle, compliance, and clinical teams to maintain proper reimbursement under government program rules. This analyst will coordinate with specialty operational units to keep up with evolving CMS rules and regulations. Some specialty areas include subacute units, a certified transplant center, a PPS-exempt dedicated cancer hospital delivering BMT and CAR-T therapies. An ideal candidate has experience in PPS and non-PPS reimbursement and a working knowledge of regulatory and compliance requirements therein.

Essential Duties:

• Support the preparation and submission of all Medicare, Medi-Cal and Tri-Care cost report filings and amendments on behalf of Keck Medicine of USC, home office and its hospitals. Review statistical, financial, and departmental data for accuracy and compliance with CMS and state regulations escalating discrepancies to the Manager as needed.
• Maintain detailed records of audits, data requests, auditor sampling, responses, and appeals. Review audit adjustments for accuracy and update internal reporting processes. Identify potential items for formal Medicare appeal and provide recommendations to the Manager for operational improvements based on audit findings,
• Prepare Medicare Cost Report (MCR)-related journal entries and balance sheet reconciliations. Support monthly settlement account estimates, related analysis, and third-party audits. Generate ad hoc reports to assist with institutional monthly financials. Respond to inquiries and other requests for information, escalating complex issues to the Manager as needed.
• Monitor and interpret CMS, Medicare, and Medicaid reimbursement, including proposed and final IPPS and OPPS rules, CMS bulletins, and related litigation. Summarize key updated and provide concise briefings to the Manager and reimbursement leadership.
• Partner with Finance, Revenue Cyle, and third-party vendors to collect and validate data for reimbursement-related activities, including Medicare bad debt, and DSH reporting. Provide analytical support and insights to Manager on reimbursement impacts and compliance.
• Perform other duties as assigned by the Manager to support the reimbursement function and broader departmental goals.

Required Qualifications:

• Req Bachelors Degree in Finance, Health Administration, Business, Accounting or related field.
• Req 3 years hospital reimbursement, with a strong focus on government payers including Medicare and Medicaid.
• Req Experience with CMS and state Medicaid hospital payment systems and cost reporting requirements.
• Experience with Medicare and Medicaid reimbursement guidelines including audits and appeals processes.
• Req Strong analytical, organizational, and communication skills.
• Req Sound business judgment and creative problem-solving attributes.
• Req Experience in GAAP and healthcare financial accounting/reporting consolidation processes.
• Req Demonstrate skills in project planning, reviewing, and ensuring work is organized and documented.
• Req Working knowledge of Hospital Revenue Cycle (Patient accounting, collections, denials, etc.) and related reporting.
• Proficiency with Microsoft Office (i.e., Excel, Word, PowerPoint).

Preferred Qualifications:

• Pref Masters degree in Accounting, Finance or Health Administration.
  

Required Licenses/Certifications:

• Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only).

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About University of Southern California (USC)

USC is the leading private research university in Los Angeles—a global center for arts, technology and international business. With more than 47,500 students, we are located primarily in Los Angeles but also in various US and global satellite locations. As the largest private employer in Los Angeles, responsible for $8 billion annually in economic activity in the region, we offer the opportunity to work in a dynamic and diverse environment, in careers that span a broad spectrum of talents and skills across a variety of academic and professional schools and administrative units. As a USC employee and member of the Trojan Family—the faculty, staff, students, and alumni who make USC a great place to work—you will enjoy excellent benefits, including a variety of well-being programs designed to help individuals achieve work-life balance.

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