Senior Reimbursement Specialist

1 week ago


Greenwood Village, Colorado, United States CommonSpirit Full time
Overview

CommonSpirit Health is a leading healthcare organization that provides comprehensive care to millions of patients across the United States. As a Senior Reimbursement Analyst, you will play a critical role in ensuring that our facilities and regions receive accurate and timely reimbursement for their services.

Responsibilities

The Senior Reimbursement Analyst will be responsible for preparing and submitting cost reports to Medicare, Medicaid, and other state and federal agencies. This will involve calculating periodic adjustments for deductions from revenue, revenue reserves, bad debt, and other revenue adjustments related to regulatory reimbursement. The successful candidate will also assist the Reimbursement Managers and/or Directors with recommendations for internal Dignity Health strategy by evaluating current growth, anticipating future needs, and assessing the impact of services delivered.

Accountabilities
  • Prepare and submit cost reports to Medicare, Medicaid, and other state and federal agencies.
  • Calculate periodic adjustments for deductions from revenue, revenue reserves, bad debt, and other revenue adjustments related to regulatory reimbursement.
  • Assist the Reimbursement Managers and/or Directors with recommendations for internal Dignity Health strategy.
  • Maintain standardized policies and procedures and third-party settlement methodologies.
  • Review operational reports, identify opportunities/problems, and make recommendations for improving processes.
Qualifications
  • Minimum of five (5) years of experience with all aspects of Medicare and Medicaid regulations, monitoring, and report processes.
  • Experience as hospital Reimbursement staff or auditing experience with Fiscal Intermediary required.
  • Minimum of five (5) years of experience and excellent working knowledge of general accounting, government reimbursement, appeals, and audits in a complex organization.
  • Experience and knowledge of current reimbursement regulations and applications in a complex healthcare environment.
  • Bachelor's degree in Business Administration, Accounting, or equivalent work experience.


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