Fiscal Analyst 3

Fiscal Analyst 3

February 4, 2021

Provides beginning to end analysis of the resident revenue cycle per each pay source, and provides professional and technical advice to WSVH business office staff, WSVH administration, and the financial services department. Manages monthly billing cycle as part of the interdisciplinary team. Revenue cycle management impacts multiple departments, the Veterans Homes Program, and contributes to the financial health of the agency.

Monthly billing to Medicaid, Medicare A and B, Managed Care, Hospice, Long Term Care insurances, and Supplemental Insurance. Performs pre-bill analysis of all bills generated for room/board and ancillary services submitted to Medicaid, Medicare A and B, Managed Care, Hospice, Long Term Care insurances, and Supplemental Insurance.

Monitors proposed, pending, and implemented changes in regulations and requirements of skilled nursing payers including Medicaid and Medicare. Analyze claims from beginning to end, working with outside providers to ensure accuracy and payment in full depending on the requirements of that payer.

Completes claims analysis on unanticipated payments or inaccurate billing. Biller analyzes claims for compliance and confirms residents meet regulatory requirements and eligibility for billing.

Provides subject matter expertise and analysis of census and payer set up in PCC. Completes daily review of resident’s accounts, based on census and payer changes, to ensure census and payer information is current.

Provides technical advice and guidance to the business office staff at the homes in order to ensure accuracy of the census and payer tree set up.

Medicare: Verification of three-night qualifying hospital stay per the paperwork and hospital billing, resident has Medicare days available and has not exhausted prior to admission, and verifies Medicare is not secondary payer or resident has not elected a Medicare Advantage plan per the Medicare Common Working File (CWF).

Medicaid/Managed Medicaid/Hospice: Verifies resident is correctly classified as Medicaid by reviewing Medicaid Award Letter completed by DSHS. If there is no award letter on file, the resident is considered Medicaid Pending. Reviews Medicaid Pending claims on a monthly basis by following up with the VBS/Admission Coordinator and verifying there is a completed Medicaid application on file with DSHS.

Veterans Administration: Completes the payer setup file and monitors the census daily for changes. When payment is received, provides a reconciliation of billed days, the 10-5588, and the monthly accruals.

Reviews vendor invoices for accurate billing to WDVA and processes applicable payments in accordance with WDVA guidelines.

Completes month-end close process, in conjunction with the business office staff, to meet designated monthly deadlines. Provides information and completes reports that are used to

Company Info

Company Name
Washington State Department of Veterans Affairs

Company URL

Contact Name
Sarah Weiher


(360) 725-2179


1102 Quince Street SE
Olympia, WA 98504