Reimbursement Specialist Sr - Financial… at INTEGRIS Health · Remote

(Core Functions - 75% of time spent) The Reimbursement Specialist Senior responsibilities include but are not limited to, the following:

• Responsible for collecting, recording and reviewing all documentation required by CMS for submission in several key areas: Organ Acquisition, Bad Debts and DSH
• Responsible for collecting, recording, reviewing, and reconciling all Physician Time Studies
• Actively participate in and contribute to ad hoc revenue analysis projects
• Preparation and submission of accurate and timely Medicare and other third-party cost reports in compliance with CMS regulations
• Manages and coordinates Medicare cost report audits including wage index, EHR and other special audits including review of proposed audit adjustments
• Assists with the identification of Medicare issues that should be appealed or reopened
• Reviews the reasonableness and accuracy of interim reimbursement rates and special payments from Medicare and third-party payors and follow up with the MAC as appropriate
• Prepares monthly contractual allowances for Medicare and Medicaid
• Prepares monthly cost report reserves schedules
• Prepares and submits annual Medicaid DSH surveys and participates in the annual Medicaid DSH audits and year end Cost Report filings
• Monitors proposed and final changes in Medicare regulations and reimbursement and provide updated schedules for the reimbursement department Reports to the System Reimbursement Director
• This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information. Strength (Lift/Carry/Push/Pull) : Sedentary (exerting up to 10 pounds of force occasionally) Standing/Walking: Occasionally; activity exists up to 1/3 of the time Keyboarding/Dexterity: Frequently; activity exists 1/3 to 2/3 of the time Talking (Must be able to effectively communicate verbally): Yes Seeing: Yes Hearing: Yes Color Acuity (Must be able to distinguish and identify colors): No No inherent job hazards. Heavy work volume and tight deadlines as well as high degree of accuracy required. May experience frequent interruptions (telephone and walk in), exposed to the anger of unsatisfied customers (physicians and public), and involved in multiple projects at any given time. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.

REQUIRED QUALIFICATIONS
EXPERIENCE:

• 3-5 years of experience in hospital third party reimbursement

EDUCATION:

• Bachelors degree in Accounting/Finance or business-related field or five years equivalent work experience 

PREFERRED QUALIFICATIONS
EXPERIENCE:

• Experience with the Medicare Administrative Contractor is highly preferred
• Experience with PeopleSoft and Epic is highly preferred