Senior Medicaid and Medicare Reimbursement Consultant

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🏈 Ohio – Remote

🏈 Ohio – Remote

⏰ Full Time

🟠 Senior

💼 Consultant

🦅 H1B Visa Sponsor

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OhioHealth

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1891

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

OhioHealth is a not-for-profit healthcare system headquartered in Columbus, Ohio, dedicated to providing exceptional patient care and a wide range of medical services. With facilities spread across multiple locations, OhioHealth offers comprehensive healthcare services including cancer care, maternity, midlife clinics for women, virtual health appointments, and specialized care for transgender and LGBTQ patients. They also focus on patient education with health and wellness classes, support groups, and health quizzes. OhioHealth is committed to improving community health through various community relations and health initiatives. They provide resources such as price transparency, financial assistance, and patient rights information to enhance the healthcare experience for all patients.

📋 Description

• Prepare and review Medicare and Medicaid cost reports for all OhioHealth entities • Ensure appropriate governmental reimbursement is received for OhioHealth • Calculate and model regulatory changes and impacts • Perform variance analysis of third-party liability accounts • Prepare supporting work papers and documentation for third-party inquiries • Provide supervisory oversight of the Reimbursement Analyst daily work schedule, information flow, teaching, work review and priorities • Support the Director of Revenue and Reimbursement and Manager of Reimbursement with revenue cycle, charge analysis, regulatory and financial reporting analyses • Serve as subject matter expert for S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, IME, GME, Governmental Logs, HCAP, UPL and Franchise Fee programs • Lead, advise and consult on reimbursement financial projects and special projects • Delegate project or process work while maintaining strategic oversight • Consult on reimbursement functions across central Ohio and non-central Ohio facilities • Provide updates to the Director of Revenue and Reimbursement and Manager of Reimbursement • Work with CGS audits and auditors • Work with legal vendor on Medicare appeals • Work with OHA and CBSA facilities on wage index opportunities

🎯 Requirements

• Bachelor's Degree in Finance (Required) • Proficiency in Microsoft applications • Knowledge of clinical and financial patient management systems • Demonstrated ability in financial analysis and cost reporting • Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement • Up-to-date knowledge of federal and state regulatory requirements • Knowledge of CMS cost reporting, disproportionate share (DSH), Uncompensated Care, bad debt reporting, IME/GME, Medicare Wage Index, S-10 reporting, Tricare and 855s, Ohio Medicaid, HCAP, UPL and Franchise Fee programs • Knowledge of Acute Care Hospitals, Critical Access Hospitals, Sole Community Hospitals and Rural Health Clinics • Knowledge of reimbursement in psychiatry, inpatient rehabilitation units, Home Health and Hospice • Strong prioritization, communication, planning and interpersonal skills • Ability to delegate work and supervise Reimbursement Analyst activities • Ability to communicate with all management levels • Ability to work in a heavily matrixed environment

🏖️ Benefits

• Full-time position • Day shift • 40 scheduled hours per week • Remote work from Ohio