POSITION SUMMARY:
The Reimbursement Manager manages and files Medicare and Medicaid cost reports and other regulatory reports, working with Medicare Audit Contractors (MACs) and Medicaid State Agencies during the audit of these cost reports, calculates reimbursement-related settlements and accruals as part of month-end close, and forecast Medicaid supplemental payment income, etc.
Essential Functions: To perform this job, an individual must perform each essential function satisfactorily with or without reasonable accommodation.
· Mitigate risk of loss of income and seize opportunities to provide value throughout the reimbursement process related to Medicare and Medicaid programs to include, but not limited to, the planning, filing, and auditing of Medicare and Medicaid cost reports for several acute care hospitals.
· Complete monthly Governmental Exhibits for the calculation of Medicare and Medicaid reimbursement-related settlements as a part of month-end close for several acute-care hospitals.
· Represent the hospitals during MAC audits of Medicare cost reports, wage index, and cost report Worksheet S-10 Uncompensated Care.
Collaborate with hospitals to ensure Medicare and Medicaid contractual accruals and settlement estimates are accurate.
· Monitor state legislative activity to ensure Lifepoint is aware of upcoming Medicaid payment changes or opportunities to influence policy.
· File Medicaid Disproportionate Share Hospital (DSH) surveys
· Work with the Governmental Relations department in monitoring Medicaid legislative changes for assigned states.
· Validate interim Medicare and Medicaid payment rates to ensure hospitals are getting paid correctly and proper payment factors are being used in accounts receivable allowance and settlements calculations.
· Process month-end close to include calculating, reviewing, and preparing entries related to state supplemental payment programs.
· Maintain regular and reliable attendance.
· Perform other duties as assigned.
ADDITIONAL INFORMATION:
· Serves both internal co-workers and external customers, clients, patients, contractors, and vendors.
· Access to and/or works with sensitive and/or confidential information.
· Exhibit an understanding of healthcare regulatory and compliance (e.g., HIPAA). Skilled in the application of policies and procedures. Knowledge of Business Office Standards and Recommended Practices.
KNOWLEDGE, SKILLS & ABILITIES: The requirements listed below are representative of the knowledge, skills and/or abilities required.
Education: Bachelor's Degree in Accounting.
Experience: Minimum of 3 years related experience in hospital reimbursement.
Certifications: Certified Professional Accountant (CPA) preferred
Travel less than 10%
Job Type: Full-time
Pay: From $90,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Schedule:
Experience:
- hospital reimbursement: 3 years (Required)
Work Location: Remote