Reimbursement Manager - Government Reimbursement - HYBRID FT Days
Position Summary: The incumbent is responsible for ensuring the accuracy and maximization of government reimbursement to all UCI Health entities. Independently performs advanced level work in ongoing government reporting and analytic services in support of the Health System's strategic missions. Charged with providing expert analytic services and consulting expertise to all levels of management. The position requires advanced level of Medicare/Medi-Cal reimbursement expertise, financial analysis, technical skills, creativity, organizational and project management ability. Background in understanding cost reports, financial modeling and general accounting principles is required. Coordinates Federal and State reporting activities to ensure that the Health System receives maximum reimbursement consistent with Federal and State regulations. Responsible for third party contractual allowance and prior year settlement schedules. Represents the Health System to state and federal agencies, prepares appeals and negotiates settlements for governmental audit disputes. Provides expert reimbursement consulting assistance to management at the Health System to promote financially sound decision making. Incumbent is a Health System liaison with agencies representing Medicare, Medi-Cal, Office of Statewide Health Planning and Development (HCAI), and CHAMPUS/Tricare. Position reports directly to the Director of Reimbursement.
Required Qualifications:
- Strong technical knowledge and skills in financial analysis
- Must demonstrate customer service skills appropriate to the job
- Must be fluent with Medicare/Medicaid regulations
- Minimum of 5 years of Medicare Cost report preparation and audit experience
- Experience working with large databases
- Exhibits excellent leadership and self-direction, good judgment in handling difficult situations and good organizational, time management, interpersonal and conflict
- Evidence of sound critical thinking skills and the ability to think creatively and strategically
- Demonstrates highly developed verbal and written communication skills, excellent analytical and problem-solving skills, the ability to assess and evaluate complex financial data, and the ability to manage multiple complex tasks. History of making recommendations using clear and concise presentations to senior leadership
- Demonstrated knowledge of Excel, Outlook, PowerPoint, Word and fluency with industry technology/tools (cost statement software, accounting/ledger, etc).
- Demonstrate sound working knowledge of the contractual allowance, bad debt, financial statement reserve process.
- Demonstrate comprehensive knowledge of net revenue, patient accounting and accounts receivable management.
- Bachelor's Degree, or equivalent education and experience
- Ability to establish and maintain effective working relationships across the Health System
Preferred Qualifications:
- Strong analytical skills and the ability to apply sound judgment in ambiguous situations
- Master's Degree in Related Field
- Experience in supervising or managing employees, including providing feedback
Total Compensation: We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.
Conditions of Employment: The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment: Background Check and Live Scan, Employment Misconduct, Legal Right to Work in the United States, Vaccination Policies, Smoking and Tobacco Policy, Drug Free Environment, and others as detailed.
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