Reimbursement Specialist

1 day ago

Charlottesville, Virginia, United States Commonwealth of Virginia Full time
Job Summary

We are seeking a highly skilled Reimbursement Specialist to join our team at the Commonwealth of Virginia. As a key member of our finance department, you will be responsible for performing a variety of tasks related to contractual allowances reimbursement cost reporting revenue budgeting and special projects.

Key Responsibilities
  • Determine transactions related to third-party reimbursement, including contractual adjustments settlements receivable (payable) Medicare and Medicaid Cost Reports appeals amendments and re-openings.
  • Maintain competency in reimbursement by keeping knowledge of current developments at the State and Federal level and through continuing education.
  • Perform or assist with profitability studies rate optimization and strategic pricing revenue volume and cost projections financial feasibility studies trend analysis and other decision support projects and reports.
  • Participate in design and planning of Hospital budget relating to rate setting and contractual adjustments.
  • Implement appropriate reporting mechanisms in conjunction with Director of Reimbursement.
  • Ensure reimbursement optimal rates and codes are implemented and communicated to the departments and help the charge master analysts in the establishment of all hospital services rates.
  • Work in conjunction with Patient Accounting staff to determine and resolve potential patient claim underpayments identified by PCON software.
  • Evaluate participating provider agreements and produce financial models for proposed agreements.
  • Meet all departmental specific competencies.
  • Adhere to medical center policies addressing infection control safety and personnel guidelines.
  • Demonstrate knowledge of and compliance with the hospital code of conduct and applicable corporate policies and procedures.
  • Maintain patient confidentiality and treat patients and their families with respect and dignity.
Requirements
  • Bachelor's Degree in Business Finance or related field is required.
  • 3 years' experience in Finance required.
  • Certified Public Accountant Fellow HFMA (FHFMA) preferred. Experience utilizing Siemen's preferred.
Physical Demands

Job requires sitting for prolonged periods. Proficient communicative auditory and visual skills; Attention to detail and ability to write legibly.

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