Reimbursement Director

1 month ago


Springfield, Illinois, United States Inova Health System Full time
Job Summary

The Sr. Reimbursement Specialist directs the development and implementation of reimbursement strategies to ensure compliance with Federal and State regulations. This role requires a strong understanding of Medicare and Medicaid reimbursement policies and procedures.

Key Responsibilities
  • Develop and implement reimbursement strategies to ensure compliance with Federal and State regulations.
  • Direct the preparation of reimbursement studies and reports as needed by senior management.
  • Research and analyze regulations related to new programs, services, and ventures.
  • Develop and maintain contractual allowances for budget projections and financial statements.
  • Evaluate interim payments from third-party payors for accuracy and adequate cash flow.
  • Coordinate with Information Systems to produce reports for cost reporting and cost analysis purposes.
  • Develop and conduct reimbursement seminars for staff of IHS operating units.
  • Manage and direct the preparation and/or review of preliminary and filed Medicare/Medicaid cost reports.
  • Review Medicare/Medicaid settlements for accuracy and impact on reimbursement for all IHS entities.
  • Coordinate support and documentation needed by independent and Medicare/Medicaid auditors.
Requirements
  • Bachelor's Degree in Business Administration or Accounting.
  • Four years of reimbursement experience in a healthcare setting with comprehensive knowledge of Medicare/Medicaid reimbursement.

This position is eligible for remote work for candidates residing in the following states - AL, AZ, DC, DE, FL, GA, KY, ME, MD, MO, NC, OH, PA, SC, TN, TX, UT, VA, WV.



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