Summary: Responsible for the creation, submission, and defense of Medicare cost reports submitted on behalf of LRH. Primarily concerned with managing, coordinating and planning the daily management of all government reimbursement requirements. Responsible for all of Medicare/Medicaid reimbursement and compliance regulations and will represent LRH with government fiscal intermediaries and works with legal counsel on appeals, audits and regulation interpretation. To insure hospital reimbursement is not adversely impacted, ensure that government filing requirements are completed on time. Value the A/R each month and perform detailed analytics ensuring all accounts are properly stated net realizable value.
- Researches, analyzes, quantifies and reviews all Medicare/Medicaid reimbursement/compliance regulations and estimates current and future effect on the organization - Works with Government fiscal intermediaries and works closely with legal council on appeals, audits and regulation interpretation - Develops methodologies and allocations required for insuring organization receives all valid reimbursement. Pursues as necessary, fiscal intermediary acceptance of changes in charging and cost reporting to insure proper reimbursement - Responsible for ensuring all governmental filings are completed accurately and on-time - Responsible for the accuracy of journal entries and analysis for monthly Medicare/Medicaid contractual allowances so that financial position accurately stated - Develops assumptions on contractual budget for strategic financial plan for all payers - Establishes, maintains, enhances and manages data integrity processes and Systems for Medicare/Medicaid reimbursement - Educates management staff on Medicare and Medicaid reimbursement issues and is the primary source organization wide on Medicare and Medicaid issues - Responsible for filing all requests for Clinical Trial approval with Medicare
Qualifications & Experience
Education: Essential: * Bachelor Degree
Essential: 5+ years of Medicare audit, reimbursement, and cost reporting experience with a
major healthcare system/facility, or three years of experience in a reimbursement role with a Medicare intermediary. At least one year supervisory or management experience.
Experience Preferred: Medicare Cost report experience with CMS or the fiscal intermediary