Reimbursement Specialist - Medicare & Medicaid Specialty Programs

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Description

JOB SUMMARY
  • Responsible for all reimbursement issues and reporting any changes in reimbursement regulations. Must be able to prepare supporting documentation and worksheets to support the preparation and completion of the Medicare and Medicaid Cost Reports. Must stay abreast of current Medicare /Medicaid regulation changes and incorporate those into the Cost Reporting. Responsible for providing assistance to related departments regarding reimbursement related issues.
GENERAL REQUIREMENTS
  • Adheres to the hospital and departmental attendance and punctuality guidelines
  • Performs all job responsibilities in alignment with the core values, mission and vision of the organization
  • Performs other duties as required and completes all job functions as per departmental policies and procedures
  • Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs)
  • Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
  • Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills.
WORKING CONDITIONS
  • General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.
  • May be exposed to limited hazardous substances or body fluids, or infectious organisms.
  • May be required to change from one task to another of different nature without loss of efficiency or composure.
  • Periods of high stress and fluctuating workloads may occur.


Qualifications

EDUCATION REQUIREMENTS
  • 2 year / Associate's Degree in Accounting, Business Administration or closely related field (Required)
  • 4 year / Bachelor's Degree in Accounting, Business Administration or closely related field (Preferred)
EXPERIENCE REQUIREMENTS
  • 3 years of Hospital Reimbursement or Accounting experience (Required)
  • 2 - 3 years of Preparation of Hospital Cost Report (Preferred)
CERTIFICATIONS AND LICENSURES
  • Preferred Certifications/Licensures: Certified Public Accountant (CPA)
GENERAL SKILLS
  • Organizational Skills
  • Communication Skills
  • Interpersonal Skills
  • Mathematical
  • Analytical
  • Grammar / Spelling
  • Read / Comprehend Written Instructions
  • Follow Verbal Instructions
  • Basic Computer Skills
  • Microsoft Office Suite
  • Understanding of healthcare cost reporting
PHYSICAL REQUIREMENTS
  • Have near normal vision - Clarity of vision (both near and far), ability to distinguish colors
PHYSICAL DEMANDS
  • Standing - Occasionally within shift (1-33%)
  • Walking - Occasionally within shift (1-33%)
  • Sitting - Continuously within shift (67-100%)
  • Lift/carry up to 20 lbs - Occasionally within shift (1-33%)
  • Lift/carry > 20 lbs with assistance - Occasionally within shift (1-33%)
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