Job Role Description

Medical/Healthcare > Cost Report Analyst (Medicare/Medicaid)

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Short Description:

A Cost Report Analyst (Medicare/Medicaid) is responsible for preparing, analyzing, and submitting cost reports in compliance with federal and state healthcare regulations. They review financial and operational data, reconcile accounts, and ensure accuracy for reimbursement under Medicare and Medicaid programs. The role involves collaborating with accounting, finance, and clinical teams to gather necessary information and support audits or regulatory inquiries. Cost Report Analysts help optimize reimbursement, maintain compliance, and provide insights into healthcare financial performance. Strong analytical, accounting, and regulatory knowledge are essential for success in this role.

Duties / Responsibilities:

  • Prepare, review, and submit Medicare and Medicaid cost reports in compliance with federal and state regulations
  • Analyze financial statements, trial balances, and supporting documentation to ensure accuracy and completeness
  • Reconcile accounts and investigate discrepancies related to hospital or healthcare provider costs
  • Collaborate with finance, accounting, and clinical departments to gather data and verify cost allocations
  • Monitor changes in Medicare/Medicaid regulations and reimbursement methodologies to maintain compliance
  • Assist in audits by preparing schedules, supporting documentation, and responding to inquiries from auditors or regulatory agencies
  • Develop and maintain cost reporting templates, schedules, and process documentation
  • Perform variance analysis and identify trends, anomalies, or potential areas for reimbursement optimization
  • Communicate findings, recommendations, and reporting requirements to management and internal stakeholders
  • Support continuous improvement initiatives to streamline cost reporting processes and enhance accuracy

Skills / Requirements / Qualifications

  • Education: Bachelor’s degree in Accounting, Finance, Healthcare Administration, or related field required; CPA preferred
  • Experience: 2–5 years of experience in healthcare accounting, cost reporting, or reimbursement analysis, preferably with Medicare/Medicaid exposure
  • Technical Skills: Proficiency in accounting software, Excel, and financial reporting tools; knowledge of cost reporting systems
  • Analytical Skills: Strong ability to analyze financial data, identify discrepancies, and ensure accurate reporting
  • Attention to Detail: Accuracy in preparing cost reports, reconciliations, and supporting schedules
  • Regulatory Knowledge: Familiarity with Medicare/Medicaid regulations, CMS guidelines, and healthcare reimbursement policies
  • Communication: Effective verbal and written skills for interacting with auditors, management, and internal departments
  • Problem-Solving: Ability to investigate issues, resolve reporting discrepancies, and implement corrective actions

Job Zones

  • Title: Job Zone Four: Considerable Preparation Needed
  • Education: Most of these occupations require a four-year bachelor's degree, but some do not. 
  • Related Experience: A considerable amount of work-related skill, knowledge, or experience is needed for these occupations. 
  • Job Training: Employees in these occupations usually need several years of work-related experience, on-the-job training, and/or vocational training.
  • Job Zone Examples: Many of these occupations involve coordinating, supervising, managing, or training others. 
  • Specific Vocational Preparation in years: 2-4 years preparation (7.0 to < 8.0)

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