Reimbursement Manager

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🔥 0 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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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

• Oversees Medicare and Medicaid cost reports submitted system wide to obtain appropriate reimbursement from these programs and monitor hospitals' compliance with internal reimbursement policies and procedures • Interprets Medicare and Medicaid regulations and directs hospital activities to comply with government payment regulations • Critically reviews proposed adjustments to cost reports and assists the Director and Vice President decide which adjustments should be appealed • Develops processes needed to complete cost reports and ensure payments for all programs and services • Develops strategies and implement processes to ensure the hospitals are in compliance with Medicare and Medicaid regulation • Responsible for the accuracy of system wide Medicare and Medicaid cost report submissions • Provides expert guidance on complying with Medicare and Medicaid reimbursement and payment regulation • Identifies opportunities to achieve reimbursement for all programs and services provided • Participates in cost report appeals and cost report group appeals • Supports the revenue budget process for items where reimbursement is calculated on the cost report • Reviews third party settlements monthly and updates in accordance with the monthly and fiscal year closing schedules • Oversees hiring, training and colleague performance • Periodically visit hospitals to assure compliance with cost reporting data collection requirements and address questions or operational challenges

🎯 Requirements

• Bachelor’s Degree in Accounting, Finance, or related field • 5 years experience interpreting Medicare and Medicaid payment regulation and completing Medicare and Medicaid cost reports • 5 years experience recording revenue and determining cost settlement receivables/payables for Medicare and Medicaid payments • 3 years in a hospital/acute care environment • High-level of MS Office skills needed • Able to train staff in technology and hospital reimbursement issues • Ability to work in a fast paced environment • Able to review large amount of data • Ability to work independently

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible working hours • Paid time off • Professional development opportunities