Finance Reimbursement Consultant (HS)

Job Description

Responsible for preparation and review of third-party report filings, including cost reports, appeals and payment calculations, for a large academic Medical Center with over 550 GME/IME FTE's, $23,000,000 of Medicare DSH reimbursement, and a TEFRA Cancer Exempt Hospital. The Reimbursement Consultant reviews monthly analysis of contractual and bad debt allowance accounts, including comparisons to the prior month and to budget. Responsible for the maintenance and development of payment factors, costing ratios and reporting formats.

The position performs variance analysis of third-party liability accounts. Also, provides supporting work papers and documentation for third-party inquiries along with reimbursement and regulatory analysis on Health System projects. Also, manages workflow processes, projects, and cost report filings for Medicare, Medicaid, and Tricare.

The Reimbursement Consultant must have the ability to articulate complex reimbursement healthcare concepts in a simplified manner to departmental and Sr. business unit leadership with regards to month end close and strategic projects throughout the organization. Also, responsible for preparing the annual forecast of the third-party reimbursement factors for the budget. Responsible for the maintenance and development of payment factors, costing ratios and reporting formats. This position provides reimbursement and regulatory analysis on Health System projects. Also, assists in evaluating the cost/quality and feasibility of new and existing programs.

This position manages workflow processes and projects and department clerical associates and Student employee associates. Under the supervision of the Administrative Director of Reimbursement, the Reimbursement Consultant is responsible for the annual filing of third-party cost reports and providing financial analysis for special projects. The Reimbursement Consultant also is responsible for achieving accurate third-party reimbursement.

Minimum Qualifications

Bachelors degree in Business Administration or related field with a major in Accounting or Finance and 6 years of hospital reimbursement experience.

A CPA certification or a Masters degree is preferred, as well as HFMA certification. Candidates should demonstrate strong technical proficiency in Microsoft Office (including Excel, Access, Word, and PowerPoint), patient accounting systems (EPIC/IHIS preferred), and HFS cost reporting software.

Our Comprehensive Employee Benefits Include:

• An array of retirement plan options, each with a generous employer contribution.
• Affordable health insurance options, including dental, vision and prescription coverage that begin on day one.
• Paid vacation and sick leave, including short and long-term disability and paid parental leave.
• Get the most out of the Public Service Loan Forgiveness program.
• And much more!