Manager Reimbursement

Lehigh Valley Health Network•REMOTE IN PENNSYLVANIA, PA

2d•Remote

About The Position

Oversees Medicare and Medicaid cost reports submitted system wide to obtain appropriate reimbursement from these programs and monitor hospitals' compliance with internal reimbursement policies and procedures. Interprets Medicare and Medicaid regulations and directs hospital activities to comply with government payment regulations. Critically reviews proposed adjustments to cost reports and assists the Director and Vice President decide which adjustments should be appealed.

Requirements

Bachelor’s Degree in Accounting, Finance, or related field
5 years experience interpreting Medicare and Medicaid payment regulation and completing Medicare and Medicaid cost reports
5 years experience recording revenue and determining cost settlement receivables/payables for Medicare and Medicaid payments
3 years in a hospital/acute care environment
High-level of MS Office skills needed
Able to train staff in technology and hospital reimbursement issues
Ability to work in a fast paced environment
Able to review large amount of data
Ability to work independently

Nice To Haves

Master’s Degree in Accounting, Finance, or related field

Responsibilities

Develops processes needed to complete cost reports and ensure payments for all programs and services.
Develops strategies and implement processes to ensure the hospitals are in compliance with Medicare and Medicaid regulation.
Responsible for the accuracy of system wide Medicare and Medicaid cost report submissions.
Provides expert guidance on complying with Medicare and Medicaid reimbursement and payment regulation.
Identifies opportunities to achieve reimbursement for all programs and services provided.
Participates in cost report appeals and cost report group appeals.
Supports the revenue budget process for items where reimbursement is calculated on the cost report.
Reviews third party settlements monthly and updates in accordance with the monthly and fiscal year closing schedules.
Oversees hiring, training and colleague performance.
Periodically visit hospitals to assure compliance with cost reporting data collection requirements and address questions or operational challenges.