Reimbursement Manager

Job not on LinkedIn

🕒 September 24

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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👻 Ghost score 24%

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Lehigh Valley Health Network

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Lehigh Valley Health Network is a comprehensive healthcare system that is now part of Jefferson Health, one of the top 15 not-for-profit health systems in the United States. It offers a wide range of medical services, including primary care, urgent care, and specialized institutes like the Lehigh Valley Topper Cancer Institute and the Lehigh Valley Heart and Vascular Institute. LVHN provides extensive care solutions, including video visits, second opinions, and a network of doctors and clinicians in numerous locations. It emphasizes education through residencies and fellowships and prioritizes patient-centric services such as lab testing and women's health care. The network also focuses on innovation, offering clinical trials and advanced therapies like CAR-T Cell Therapy.

📋 Description

• Interpret Medicare and Medicaid regulation and direct hospital activities to comply with government payment regulation and optimize Medicare and Medicaid revenue • Develop and execute processes to gather information required for Medicare and Medicaid cost reports • Complete cost reports accurately and by filing due dates • Calculate financial impacts of purchasing, readmissions, hospital acquired infections, and accountable care arrangements • Develop strategies and implement processes to ensure hospital compliance with Medicare and Medicaid regulation • Develop processes needed to complete cost reports and ensure payment for all programs and services • Provide expert guidance on Medicare and Medicaid reimbursement and payment regulation • Identify opportunities to achieve reimbursement for all programs and services provided • Support participation in cost report appeals and cost report group appeals • Evaluate firms organizing group appeals and recommend firms and consultants for preparing and following appeals • Support the revenue budget process for items where reimbursement is calculated on the cost report • Review third-party settlements monthly and update them according to monthly and fiscal year-end closing schedules

🎯 Requirements

• Bachelor's Degree • 5 years interpreting Medicare and Medicaid payment regulation and completing Medicare and Medicaid cost reports • 5 years recording revenue and determining cost settlement receivables/payables for Medicare and Medicaid payments • Ability to work independently • Ability to lift and carry 25 lbs. • Frequent sitting/standing • Frequent keyboard use

🏖️ Benefits

• Equal opportunity employment • Day shift schedule • Monday-Friday 8:00A-4:30P • Remote work in Pennsylvania

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