SummaryOversees Medicare and Medicaid cost reports submitted system wide to obtain appropriate reimbursement from these programs and monitor hospitals' compliance with internal reimbursement policies and procedures. Interprets Medicare and Medicaid regulations and directs hospital activities to comply with government payment regulations. Critically reviews proposed adjustments to cost reports and assists the Director and Vice President decide which adjustments should be appealed.
Job Duties- Develops processes needed to complete cost reports and ensure payments for all programs and services.
- Develops strategies and implement processes to ensure the hospitals are in compliance with Medicare and Medicaid regulation.
- Responsible for the accuracy of system wide Medicare and Medicaid cost report submissions.
- Provides expert guidance on complying with Medicare and Medicaid reimbursement and payment regulation.
- Identifies opportunities to achieve reimbursement for all programs and services provided.
- Participates in cost report appeals and cost report group appeals.
- Supports the revenue budget process for items where reimbursement is calculated on the cost report.
- Reviews third party settlements monthly and updates in accordance with the monthly and fiscal year closing schedules.
- Oversees hiring, training and colleague performance.
- Periodically visit hospitals to assure compliance with cost reporting data collection requirements and address questions or operational challenges.
Minimum Qualifications- Bachelor's Degree in Accounting, Finance, or related field
- 5 years experience interpreting Medicare and Medicaid payment regulation and completing Medicare and Medicaid cost reports and
- 5 years experience recording revenue and determining cost settlement receivables/payables for Medicare and Medicaid payments and
- 3 years in a hospital/acute care environment
- High-level of MS Office skills needed
- Able to train staff in technology and hospital reimbursement issues
- Ability to work in a fast paced environment
- Able to review large amount of data
- Ability to work independently
Preferred Qualifications- Master's Degree in Accounting, Finance, or related field
Physical DemandsLift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.
Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.
Work Shift:Day Shift
Address:1200 S Cedar Crest Blvd
Primary Location: REMOTE IN PENNSYLVANIA
Position Type:Remote
Union:Not Applicable
Work Schedule:8:00A-5:00P
Department: 
