- Hourly / - BiWeekly /
- Monthly / $44,106.00-$70,201.00 Yearly
Health Services Rate Analyst Trainee is the trainee level of work setting rates hospitals charge for health services and auditing hospital records for compliance with established rates. Employees in this classification do not supervise.
Employees in this classification receive close supervision from a Health Services Rate Analyst Supervisor.
Health Services Rate Analyst Trainee, Health Services Rate Analyst I and Health Services Rate Analyst II are differentiated on the basis of degree of supervisory control exercised by the supervisor over these employees. The Health Services Rate Analyst Trainee learns to perform duties under close supervision, the Health Services Rate Analyst I performs duties under close supervision at times and under general supervision at other times depending on the complexity of the specific duty being performed and the Health Services Rate Analyst II performs the full range of duties under general supervision.
Learns to review financial data from hospitals for completeness, accuracy, validity and adequacy for rate setting purposes;
Learns to determine the scope and nature of analysis of financial data required to set reasonable rates to be charged for health services;
Learns to perform calculations to develop inflation factors, inpatient rate changes, price leveling factors and case mix adjustments on inflation adjustments;
Learns to apply appropriate rate setting methodologies required for inflation adjustments, guaranteed inpatient revenue adjustments and whole or partial rate reviews;
Learns to modify rate setting methodologies for special factors or circumstances such as rate reductions and changes in intensity factors;
Learns to prepare manual and computerized work papers to document the rate setting process;
Learns to discuss proposed rates with hospital officials, physicians and health insurance officials to gather information and explain the basis of rate proposals;
Learns to present empirical evidence summarized into staff recommendations to the Health Services Cost Review Commission (HSCRC) on the effectiveness and efficiency of proposed rates;
Learns to prepare testimony and provide background information for presentation at formal and informal hearings to explain and defend rate reviews and analyses;
Learns to audit annual financial statements of hospitals;
Learns to assist with proposed spend downs for hospitals to bring health services rates down to reasonable levels;
Learns to interpret and apply HSCRC regulations and policies in the review of hospital rate proposals;
Performs other related duties.
Knowledge of generally accepted accounting principles, theory, procedures and methods;
Knowledge of generally accepted auditing standards;
Knowledge of cost accounting principles, theory, procedures and methods as related to the provision of health services;
Knowledge of business administration and management practices;
Ability to use computerized fiscal applications and software;
Ability to communicate effectively;
Ability to establish and maintain effective working relationships with HSCRC staff, accountants, auditors, data processing staff, attorneys, hospital officials, physicians and representatives of health insurance companies;
Ability to learn HSCRC rate setting methodologies;
Ability to learn to analyze and interpret hospital financial reports and statements;
Ability to learn to apply health services rate setting principles and methodologies;
Ability to learn to modify health services rate setting methodologies as needed to meet unusual circumstances;
Ability to learn to document and defend HSCRC rate setting proposals.
Education: A bachelor's degree in accounting, finance, economics, hospital administration or health care administration from an accredited college or university.
Experience: Two years of experience examining, analyzing and interpreting accounting systems, records and reports by applying generally accepted accounting principles or conducting financial audits that include elements for finance and compliance, economy and efficiency and program results.
Experience setting rates hospitals charge for medical services and auditing hospital records for compliance with established rates may be substituted for the required college education on a year for year basis.