Financial Administration Specialist

Job Title

Financial Administration Specialist

Job Description

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• Monitors Third Party Payer (TPP) reimbursement and verifies that reimbursements are consistent and in accordance with laws, regulations and specific insurance policy provisions;
• Conducts monthly in-depth payer variance reviews to identify trends and opportunities.
• Develops action plans with TPPs to bring payment practices into compliance with federal statutes and regulations.
• Establishes and maintains solution-oriented relationships with internal and external stakeholders to include VA revenue departments, VAMC, VISN, and TPP points of contact and documents issues and solutions related to claim processing and reimbursement requirements to influence the VA revenue program.
• Evaluates VA's operational compatibility with payer rules and requirements; understanding of medical terms, CPT, HCPCS, DRG codes and applicability to the revenue cycle (Coding certification is NOT required, just familiarity with codes and relation to reimbursement).
• Leads discussions with TPPs and assists in escalating issues to the VA Office of General Counsel, seeing timely advice in the resolution of systemic or long-standing reimbursement issues, disputes, or non-compliance matters relating to agreement terms or federal regulations.

Work Schedule: Monday - Friday; 40 hrs per week; Tour will be set upon selection

Compressed/Flexible: Not Available

Telework: This position may be authorized for telework. Telework eligibility will be discussed during the interview process.

Virtual: This is not a virtual position.

Position Description/PD#: Financial Administration Specialist/ PD73010A

Relocation/Recruitment Incentives: Not Authorized

Critical Skills Incentive (CSI): Not Approved

Permanent Change of Station (PCS): Not Authorized