Summary:

Assist in the supervision of Medicare and Medicaid cost report preparation, review, and audit.  Successful candidate will be a resource to division, provider facility and department staff.  Must understand Medicare and Medicaid reimbursement principles, data sources, and necessary supporting work papers.  Consultant will actively participate in continuous improvement initiatives to include redesign of workflow.  Must possess excellent oral/written communication skills.

Essential Functions:

• Actively participate in department’s mission to prepare, review and submit Medicare and Medicaid cost reports.

• Assist in review of annual rate updates and new reimbursement regulations including cost report changes for all provider types and develop new processes/procedures as necessary to comply with any changes in reporting requirements.

• Assist with oversight and management of internal and external audits.

• Actively participate in continuous improvement initiatives, including study of workflow redesign, identification and deployment of systems solutions, and  developing workload plans and staff assignments.

• Review monthly revenue accruals and/or contractual adjustments.

• Train staff in reimbursement tasks and assist in review of staff work, provide input on staff performance appraisals.

• Participate in transaction due diligence and integration of new acquisitions into department processes.

• Reconcile reimbursement settlement accounts for facilities and assist managers in review of Analysts' reconciliations.

• Provide technical expertise and analytical support for government reimbursement matters.

• Assist in development of policies, procedures, reports, and other tools to improve work product. Work directly with Reimbursement department leadership on planning, training, and special projects as necessary.

• Work directly with Reimbursement department leadership on planning, training, and special projects as necessary

• Collaborate with others, set priorities, multitask, work well with deadlines and other time pressures.

• Independently manage special projects to completion as assigned.  

Knowledge/Skills/Abilities:

• Demonstrated proficiency in Medicare principles of reimbursement, CMS cost reporting requirements, MAC relations and audit process.

• General experience with state Medicaid programs and related reporting requirements.

• Excellent communication, organization, and analytical skills.

• Advanced Excel skills and proficient use of Word, PowerPoint, and other relevant software.

Education: 

• Bachelor’s degree in accounting, finance, systems or other degree with equivalent experience.

Experience:

• Minimum 5 to 7 years healthcare reimbursement experience (preferably with multiple providers) with a hospital or hospital chain, consulting or CPA firm, Medicare Administrative Contractor, or similar.

• Experience should include training, supervision, review of reimbursement functions and third party payor accounting.

• Knowledge of GAAP accounting.
• Excellent analytical skills.
• Excellent oral/written communication skills.  

Depending on a candidate’s qualifications, this position may be filled at a different level.

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