State of Idaho
Job Posting for Reimbursement Analyst – Medicaid Bureau of Financial Operations at State of Idaho
The Idaho Department of Health and Welfare, Division of Medicaid, is currently seeking a Medicaid Reimbursement Analyst. This position is located in the Bureau of Financial Operations in Boise.
We are seeking candidates with strong leadership abilities; experience researching and analyzing documents to ensure compliance with federal and state laws, regulations, and accounting principles; communication and interpersonal skills; problem solving skills; critical thinking skills and team learning competencies.
The ideal candidate is one with the ability to multi-task, work independently and have strong organization skills as well as detail orientation. The primary focus is to manage and create appropriate reimbursement for state services. These services include multiple provider types, such as hospitals, nursing facilities, durable medical equipment suppliers, school-based service providers. The Reimbursement Analyst is responsible for updating rates, verifying payments, calculating payments, creating policy, managing provider interaction, and reviewing reimbursement methods. These responsibilities will need to comply with regulatory requirements at both a State and Federal level. In addition, strong communication skills are required to help resolve issues with internal and external stakeholders or pending payments from government and third-party payers.
We offer a competitive benefits package which includes excellent medical, dental and vision insurance; generous vacation and sick leave accrual beginning as soon as you start; eleven paid holidays a year; participation in one of the Nation’s best state retirement systems; multiple savings plans and optional 401K; life insurance; wellness programs; ongoing training opportunities; optional telework, hybrid, or flex scheduling; and more.
If you have previously applied for the Reimbursement Analyst (Financial Specialist Senior) and wish to be considered for this vacancy, you must reapply under this announcement. Previous scores will not be used.
- Assists in review, understanding, and application of federal and state rules, regulation, guidelines, and trends and make recommendations for policy changes related to healthcare procedure codes and Medicaid reimbursement activities.
- Collaboration with technical resources and managers across the division to ensure application of rules, regulation, and guidelines are understood, communicated, and followed for reimbursement activities.
- Assists in review and analysis of Medicaid reimbursement practices, policies, and procedures to optimize reimbursement activities.
- Applies reimbursement rules and regulations to respond to questions or provide updates to internal and external stakeholders.
- Works with management to draft rule changes.
- Works with management to draft state plan amendments and waiver applications.
- Supports the development and maintenance of financial policies and procedures.
- Audit financial data for completeness and compliance with federal and state laws and regulations and conducts research into the financial needs of Medicaid.
- Assist with routine cost and analysis functions relating to provider payments and reimbursement activities.
- Consistently shows ability to recognize and deal with priorities.
- Demonstrates good judgment and reasoning when investigating and solving problems.
- Assist with other duties, tasks, or assignments as assigned by management.
You must possess all the minimum qualifications listed below to pass the exam for this position. Click on the Questions tab associated with this announcement for the details regarding minimum qualification requirements. The Supplemental Questions on the application are the exam questions. If it is a written answer, please make sure you answer each question with enough detail to determine how you meet the requirements. Do not put “See resume” as your answer to written questions. Answer each written question thoroughly. Failure to do this may result in not passing the exam and disqualify you from being considered for this position.
- Good knowledge of accounting principles and practices
- Experience developing and preparing financial documents
- Experience using a personal computer to develop, analyze, and report on financial data
- Experience analyzing financial activities and recommending management action
Additional Qualifications: Are not required; however, having the minimum qualifications and the education and/or experience below will increase your score.
- Experience using data extraction tools and methods for analysis, sampling, testing and reporting. Gained by one (1) year of related full-time work experience.
- Knowledge of Private or Public Healthcare. Gained by one (1) year of experience in a public or private health care setting or insurance billing clearing house where use of medical codes was a function of the job.
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Hiring is done without regard to race, color, religion, national origin, sex, age or disability. If you need special accommodations to satisfy testing requirements, please contact the Division of Human Resources at (208) 334-2263.
Preference may be given to veterans who qualify under state and federal laws and regulations.
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