Senior Reimbursement Specialist

Job Summary 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 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 Bachelor's Degree (Required) Master’s Degree (Preferred) Experience Requirements 5-6 Years hospital rehabilitation (Required) 5-6 Years hospital cost report preparation (Required) Certifications and Licensures Certified Public Accountant (CPA) – Preferred Essential Functions Ensure compliance with ICTF, DSH, and 340b rules and maximize revenue from these programs. Lead coordination of the entire ICTF process, determine intergovernmental transfer amount, and coordinate filings for receipt of funds. Prepare the annual hospital financial survey. Analyze and develop financial data for profitability studies, budgeted deductions, and other data analysis. Accurately complete requests for reimbursement information from internal and external customers. Work with departments to maximize Medicare/Medicaid reimbursement. Compute and analyze budgeted deductions from revenue. Complete month‑end and year‑end reimbursement journal entries. Assist in analyzing managed care contracts. File government payer provider applications. Ensure all cost reports (Medicare, Medicaid, Tri‑Care, etc.) are completed accurately and revenue is maximized from reporting and programmatic perspectives. Coordinate cost reporting for hospitals in the Health System and serve as a resource for rural hospitals. Direct documentation preparation during audits and keep knowledge current on Medicare and Medicaid regulations. Additional Duties Adhere to hospital attendance and punctuality guidelines. Perform all responsibilities aligned with the core values, mission, and vision of the organization. Maintain current knowledge through self‑education and ongoing educational programs. Attend staff meetings, complete mandatory in‑services, and meet competency evaluation deadlines. Demonstrate competency across all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. #J-18808-Ljbffr