SENIOR REIMBURSEMENT SPECIALIST

SENIOR REIMBURSEMENT SPECIALIST

RESPONSIBILITIES
• Strong familiarity with Medicare and Medicaid cost reports to prepare work papers for third-party costs reports and utilizes outside consultants as appropriate and assist in various phases of third-party cost report audit.
• Assist in various phases of annual independent audit by Certified Public accounting firm as well as mid-year review of third-party contractual allowances.
• Interaction with the consulting firm that assists with cost reports and reimbursement issues/studies.
• Assist with preparation of monthly financial reimbursement model for monthly accounting closes. Interacts with Manager of Revenue Integrity and Finance Director.
• Assists in preparation and analysis of internal periodic departmental/product line analysis.
• Assists with periodic cost accounting analysis including development of pricing for new services not covered by payers, analysis of new services and gain/loss on implementation of new service.
• Assist in contract analysis and negotiations by providing reimbursement analysis on a variety of fee schedules, CPT/HCPCs codes.
• Assist with financial forecasts and assist with annual revenue budget.
• Assist with annual budget for third-party contractual allowances.
• Demonstrates knowledge of and supports hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality statements, corporate compliance plan, customer service standards, and the code of ethical behavior.
• Other duties as assigned