Job Description

Senior Reimbursement Specialist at Phoebe Putney Health System summary:

The Senior Reimbursement Specialist manages reimbursement processes and ensures compliance with Medicare and Medicaid regulations, preparing and analyzing cost reports to maximize hospital revenue. They coordinate the ICTF process, assist departments with reimbursement issues, and handle provider enrollment applications for hospitals within the health system. This role requires expertise in regulatory reimbursement, financial data analysis, and strong collaboration across internal and external stakeholders to support accurate cost reporting and audits.

JOB SUMMARY: No Remote
Responsible for all reimbursement issues and reporting any changes in reimbursement regulations. Must be able to prepare supporting documentation and worksheets to support the preparation and completion of the Medicare and Medicaid Cost Reports. Must be able to analyze and respond to Medicare Medicaid inquiries or audits. Must stay abreast of current Medicare/Medicaid regulation changes and incorporate those into the Cost Reporting. Responsible for providing assistance to related departments regarding related issues. Responsible for preparing provider-based applications and any other necessary changes related to provider enrollment for the hospitals in the System.

EDUCATION REQUIREMENTS
4 year Bachelor's Degree (Required) Accounting or Finance preferred
Master's Degree (Preferred)

EXPERIENCE REQUIREMENTS
5 Years hospital reimbursement (Required)
5 Years hospital cost report preparation (Required)

 

CERTIFICATIONS AND LICENSURES
Preferred Certifications Licensures: Certified Public Accountant (CPA)

ESSENTIAL FUNCTIONS
Understands and ensures organizational compliance with all ICTF, DSH, 340b rules and regulations while maximizing organizational revenue from these programs
Takes the lead role in coordinating the entire ICTF process.
Determines ICTF intergovernmental transfer amount and coordinates appropriate filings for receipt of funds.
Prepares annual hospital financial survey.
Knowledge base, in regulatory reimbursement/accounting, utilized to analyze and develop financial data for profitability studies, budgeted deductions, and other data analysis.
Accurately and timely completes requests for reimbursement information from both internal and external customers.
Works with individual departments to maximize Medicare/Medicaid reimbursement.
Accurately computes and analyzes budgeted deductions from revenue.
Completes month-end and year-end reimbursement journal entries.

Provides assistance in analyzing managed care contracts.
Completes and files government payor provider applications.
Completes and files government payor provider applications.
Ensures all cost reports (Medicare, Medicaid, Tri-Care, et al) are completed accurately and that corresponding revenue is maximized from both a reporting and programmatic perspective
Coordinates cost reporting for Hospitals under the Health System and serves as a resource for rural hospitals.
Directs preparation of documentation for cost report during audit.
Keeps knowledge current on all Medicare and Medicaid regulations and identifies

Keywords:

Medicare reimbursement, Medicaid cost reporting, hospital finance, ICTF coordination, provider enrollment, healthcare audits, cost report preparation, regulatory compliance, financial data analysis, managed care contracts

Job Tags

Full time,

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