Reimbursement Specialist

To perform the functions of contractual allowances reimbursement cost reporting revenue budgeting and special projects. To implement changes resulting from research of laws and regulations issued by Medicare Medicaid and other third party payers. To prepare monthly analyses related to allowances for contractual adjustments and bad debts as well as cost report settlements receivable (payable). To prepare annual cost reports and be point of contact for intermediary audits reviews and appeals. To implement rate optimization analyses and changes. To closely interact with Director of Reimbursement on reimbursement budget and cost issues.

• Determines transactions related to third-party reimbursement including contractual adjustments settlements receivable (payable) Medicare and Medicaid Cost Reports appeals amendments and re-openings.
• Maintains competency in reimbursement by keeping knowledge of current developments at the State and Federal level and through continuing education.
• Performs or assists with profitability studies rate optimization and strategic pricing revenue volume and cost projections financial feasibility studies trend analysis and other decision support projects and reports.
• Participates in design and planning of Hospital budget relating to rate setting and contractual adjustments.
• Implements appropriate reporting mechanisms in conjunction with Director of Reimbursement.
• Ensures reimbursement optimal rates and codes are implemented and communicated to the departments and helps the charge master analysts in the establishment of all hospital services rates.
• Works in conjunction with Patient Accounting staff to determine and resolve potential patient claim underpayments identified by PCON software.
• Evaluates participating provider agreements and produces financial models for proposed agreements.
• Meets all departmental specific competencies.
• Adheres to medical center policies addressing infection control safety and personnel guidelines.
• Demonstrates knowledge of and compliance with the hospital code of conduct and applicable corporate policies and procedures.
• Maintains patient confidentiality and treats patients and their families with respect and dignity.
• In addition to the above job responsibilities, other duties may be assigned.

MINIMUM REQUIREMENTS

Education: Bachelor's Degree in Business Finance or related field is required.

Experience: 3 years' experience in Finance required.


Licensure: Certified Public Accountant Fellow HFMA (FHFMA) preferred. Experience utilizing Siemen's preferred.


PHYSICAL DEMANDS

Job requires sitting for prolonged periods. Proficient communicative, auditory and visual skills; Attention to detail and ability to write legibly.


The pay range for this role is $67,849.60 - $127,890.00 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.

Job Profile
J1141 - Business and Finance Professional 2

Career Stream and Level
Professional-P2

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA's commitment to non-discrimination and equal opportunity employment .

Each agency within the Commonwealth of Virginia is dedicated to recruiting, supporting, and maintaining a competent and diverse work force. Equal Opportunity Employer