Reimbursement Manager (Hybrid)
About The Position
In this highly analytical role, you will lead the preparation and review of financial and statistical information for Medicare and Medi-Cal cost reports. You will collaborate across departments to ensure compliance, optimize reimbursement, and support audit processes. You will: Prepare, review, and analyze financial and statistical data for Medicare and Medi-Cal cost reports. Serve as the primary contact for Medicare and Medi-Cal audits, supporting auditors and resolving inquiries. Calculate net revenue, contractual allowances, and third-party payer expenses. Analyze hospital accounts receivable models and other financial data. Prepare Medi-Cal P14 waiver reports and respond to waiver audits/questions. Develop reports detailing reimbursement trends, regulatory impacts, and financial forecasts. Support audit requests from financial, federal, and state agencies. Calculate annual PPS Medicare rates for internal hospital coding.
Requirements
- Bachelor's degree in Accounting, Finance, Healthcare Administration, or a related field, or equivalent experience.
- 8+ years of experience in healthcare reimbursement, financial analysis, or a related field.
- Advanced knowledge of Medicare, Medi-Cal, and third-party payer reimbursement systems and regulations.
- Expertise in financial modeling, data analysis, and statistical reporting techniques.
- Strong knowledge of regulatory compliance and cost report preparation.
- Advanced proficiency with financial analysis tools, including Excel and healthcare-specific software.
- Excellent communication skills, with the ability to present complex financial data to diverse audiences.
- Strategic thinking and problem-solving abilities.
- Demonstrated ability to mentor and lead teams in a dynamic healthcare environment.
Responsibilities
- Prepare, review, and analyze financial and statistical data for Medicare and Medi-Cal cost reports.
- Serve as the primary contact for Medicare and Medi-Cal audits, supporting auditors and resolving inquiries.
- Calculate net revenue, contractual allowances, and third-party payer expenses.
- Analyze hospital accounts receivable models and other financial data.
- Prepare Medi-Cal P14 waiver reports and respond to waiver audits/questions.
- Develop reports detailing reimbursement trends, regulatory impacts, and financial forecasts.
- Support audit requests from financial, federal, and state agencies.
- Calculate annual PPS Medicare rates for internal hospital coding.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Industry
Educational Services
Number of Employees
5,001-10,000 employees
