Manager-Reimbursement Senior
About The Position
Job Summary Assist in operational oversight for the government programs reporting reimbursement function. Responsibilities Helps oversee the filing of annual Medicare, Medicaid, and Tricare cost reports along with all audits, surveys, and appeals related to such reports. Enhances the cost report process to ensure compliant, accurate, and timely reporting of such reports by documenting processes/steps taken to file reports and updates as weaknesses/strengths are found. Assists 3rd party consultants in specified payment areas related to the government reimbursement reporting function. Ensures 3rd party balance sheet accounts for all entities with costs reporting generated settlements, are maintained and calculates/recommends reserves as needed. Calculates and assimilates appeals requested so as to determine cost/benefit analysis of pursuing with regard to the identified issues. Reviews all Medicare Reimbursement Rates as they arise, assimilates Pricers, and submits information to BOC team for updates in patient accounting system. Reviews year-end calculated estimates are well documented. Assists in quantifying reimbursement projections during budget season. Performs Other Duties as Assigned. Specifications Experience Minimum Required 8+ years finance leadership with solid background of government reimbursement reporting processes. Experience in large hospital and/or healthcare system. Preferred/Desired Education Minimum Required BS in Finance, Business or related field Preferred/Desired Master's degree and/or CPA Training Minimum Required Comprehensive knowledge of all government reimbursement-related regulations of Medicare and Medicaid. Preferred/Desired Special Skills Minimum Required Preferred/Desired Licensure Minimum Required Preferred/Desired
Requirements
- 8+ years finance leadership with solid background of government reimbursement reporting processes.
- Experience in large hospital and/or healthcare system.
- BS in Finance, Business or related field
- Comprehensive knowledge of all government reimbursement-related regulations of Medicare and Medicaid.
Nice To Haves
- Master's degree and/or CPA
Responsibilities
- Helps oversee the filing of annual Medicare, Medicaid, and Tricare cost reports along with all audits, surveys, and appeals related to such reports.
- Enhances the cost report process to ensure compliant, accurate, and timely reporting of such reports by documenting processes/steps taken to file reports and updates as weaknesses/strengths are found.
- Assists 3rd party consultants in specified payment areas related to the government reimbursement reporting function.
- Ensures 3rd party balance sheet accounts for all entities with costs reporting generated settlements, are maintained and calculates/recommends reserves as needed.
- Calculates and assimilates appeals requested so as to determine cost/benefit analysis of pursuing with regard to the identified issues.
- Reviews all Medicare Reimbursement Rates as they arise, assimilates Pricers, and submits information to BOC team for updates in patient accounting system.
- Reviews year-end calculated estimates are well documented.
- Assists in quantifying reimbursement projections during budget season.
- Performs Other Duties as Assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Number of Employees
5,001-10,000 employees
