Sr. Reimbursement Specialist
- Req. Number: 9452
- Address: 3200 Burnet Ave
- City, State: Cincinnati, OH
- Job Type: Full time
- Posted Date: 9/14/2023
Job Description
UC Health is hiring a Full Time Sr. Reimbursement Specialist.
This position will provide support to the Governmental Reimbursement function for UC Health, including support to the Director of System Governmental Reimbursement, as well as system and facility finance leaders, including Chief Financial Officers. The Sr Reimbursement Specialist will report directly to the Director, System Governmental Reimbursement.
Primary areas of focus will include governmental cost report preparation for all UC Health facilities, HCAP filings, monthly net revenue analysis and audit resolution. This position will also serve as a key player in development of standardized processes and automation for bad debt reporting, disproportionate share reporting and cost report documentation. The Sr Reimbursement Specialist will serve as one of the subject matter experts in Medicare and Medicaid program evaluations, regulations, and interpretations.
Responsibilities
Qualifications
UC Health is hiring a Full Time Sr. Reimbursement Specialist.
This position will provide support to the Governmental Reimbursement function for UC Health, including support to the Director of System Governmental Reimbursement, as well as system and facility finance leaders, including Chief Financial Officers. The Sr Reimbursement Specialist will report directly to the Director, System Governmental Reimbursement.
Primary areas of focus will include governmental cost report preparation for all UC Health facilities, HCAP filings, monthly net revenue analysis and audit resolution. This position will also serve as a key player in development of standardized processes and automation for bad debt reporting, disproportionate share reporting and cost report documentation. The Sr Reimbursement Specialist will serve as one of the subject matter experts in Medicare and Medicaid program evaluations, regulations, and interpretations.
Responsibilities
- Develops and documents standardized and automated processes for annual reimbursement projects including, but not limited to, disproportionate share reporting, bad debts, HCAP filings and cost reports.
- Manages HCAP filings and audits with education and support for internal resources, external consultants and statewide auditors.
- Acts as an independent consultant for finance leadership from assigned UC Health entities.
- Works independently to review and interpret legislative and other programmatic changes to Medicare and Medicaid programs, and advise management and service line teams of financial impact of these changes.
- Prepares analysis of contractual allowances and third party liabilities.
- Responsible for working with outside auditors and consultants to resolve reimbursement issues.
- Other ad hoc items.
Qualifications
- Minimum Required: Bachelor's Degree in Business Administration (Accounting/Finance-Preferred), or in Reimbursement
- Minimum Required: 7 - 9 Years equivalent experience
- Preferred: MBA or/and HFMA's Certified Healthcare Financial Professional (CHFP)
- Preferred: 8 - 10 Years equivalent experience
- Knowledgeable of cost reporting software packages is required.
- Expertise and extensive experience with Excel, including pivot tables, vlookups, conditional formatting, functional knowledge and filtering is required.
- Experience with Access, EPSi, and Oracle G/L software tools are preferred.
- The ability to research reimbursement topics via the CMS website, Code of Federal Regulations (CFR), and Provider Reimbursement Manuals (PRM) is preferred.
- Experience in Medicare cost report preparation involving bad debts, graduate medical education (GME), indirect medical education (IME), organ acquisition, disproportionate share hospital (DSH), and paramedical education programs.
