Senior Reimbursement Specialist – Financial Reporting

📋 Description

• Accountable for gathering, documenting, and reviewing all necessary paperwork mandated by CMS for submission in several critical areas: Organ Acquisition, Bad Debts, and DSH.

• Responsible for the collection, recording, review, and reconciliation of all Physician Time Studies.

• Actively engage in and contribute to various ad hoc revenue analysis projects.

• Prepare and submit accurate and timely Medicare and other third-party cost reports in accordance with CMS regulations.

• Manage and coordinate Medicare cost report audits, including wage index, EHR, and other special audits, while reviewing proposed audit adjustments.

• Assist in identifying Medicare issues that need to be appealed or reopened.

• Evaluate the reasonableness and accuracy of interim reimbursement rates and special payments from Medicare and third-party payors, following up with the MAC as necessary.

• Prepare monthly contractual allowances for Medicare and Medicaid.

• Develop monthly cost report reserves schedules.

• Prepare and submit annual Medicaid DSH surveys and participate in the annual Medicaid DSH audits and year-end Cost Report filings.

• Monitor proposed and finalized changes in Medicare regulations and reimbursement, providing updated schedules for the reimbursement department.

⛳️ Requirements

• 3-5 years of experience in hospital third-party reimbursement.

• Bachelor's degree in Accounting/Finance or a business-related field, or five years of equivalent work experience.

• Experience with the Medicare Administrative Contractor is strongly preferred.

• Familiarity with PeopleSoft and Epic is highly preferred.

🏝️ Benefits

• Front-loaded PTO.

• 100% INTEGRIS Health paid short-term disability.

• Increased retirement match.

• Paid family leave.