Reimbursement Manager

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Analyze Medicare and Medicaid regulations, guiding hospital operations to ensure compliance with government payment guidelines while maximizing Medicare and Medicaid revenue.

• Design and implement procedures for collecting necessary information for Medicare and Medicaid cost reporting.

• Accurately prepare and submit cost reports by their respective deadlines.

• Assess the financial implications of purchasing decisions, readmissions, hospital-acquired infections, and accountable care arrangements.

• Formulate strategies and establish processes to guarantee hospital adherence to Medicare and Medicaid regulations.

• Create the necessary procedures for completing cost reports and securing payments for all programs and services.

• Offer expert advice regarding Medicare and Medicaid reimbursement and payment regulations.

• Recognize opportunities to ensure reimbursement for all services and programs rendered.

• Assist in the participation of cost report appeals and collective cost report appeals.

• Evaluate firms involved in organizing group appeals and recommend suitable firms and consultants for preparing and managing appeals.

• Support the revenue budgeting process for items where reimbursement is determined based on the cost report.

• Review monthly third-party settlements and update them according to monthly and fiscal year-end closing schedules.

⛳️ Requirements

• Bachelor's Degree.

• 5 years of experience in interpreting Medicare and Medicaid payment regulations and preparing Medicare and Medicaid cost reports.

• 5 years of experience in recording revenue and determining cost settlement receivables/payables for Medicare and Medicaid payments.

• Capability to work independently.

• Ability to lift and carry 25 lbs.

• Frequent sitting and standing required.

• Regular use of a keyboard is necessary.

🏝️ Benefits

• Equal opportunity employment.

• Day shift schedule.

• Monday-Friday from 8:00 AM to 4:30 PM.

• Remote work available in Pennsylvania.