Senior Reimbursement Specialist

Job Summary: Coordinates and prepares all third-party cost report filings, associated audits and appeals, and other regulatory filings. Prepares, with limited guidance, more complex cost report worksheets including Bad Debts, Wage Index, DSH and S-10. Researches, creates, and maintains all reimbursement related information and data to ensure regulatory compliance. Develops and updates models and forecasts to determine financial and reimbursement impacts of various regulatory changes. Represents the department in New Service meetings and provides reimbursement analysis and Payer coverage positions to support the Value Analysis Teams. Assists with Payer contract analysis and modeling to support Managed Care Teams. Calculates monthly contractual allowances, posts journal entries, and explains variances to budget and prior periods.

Qualifications: BA or BS in Accounting, Finance, Business Administration or related field from an accredited college or university. At least 5 years of progressive healthcare experience working as a Reimbursement Analyst in a hospital, a Medicare Administrative Contractor (MAC), and/or a professional audit or consulting firm focusing on cost reporting and healthcare reimbursement. Must have specific direct experience in completing and filing a complete cost report with working knowledge of all cost report worksheets. Additional experience in accounting, auditing and/or contract modeling preferred. Possesses a complete understanding of technical principles, theories and concepts related to payer reimbursement and is able to apply them to various issues. Proficient computer skills including Cost Reporting Software and Microsoft Office required. Experience with EPIC operating system preferred. Must be analytical, detail-orientated, self-motivated and able to work with minimal supervision. Excellent interpersonal and communication skills are required in frequent interaction with Government Agencies, Auditors, Department Directors/Managers and employees.

EOE AA M/F/Vet/Disability

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