Reimbursement Specialist III
Company: Hackensack Meridian Health
Posted on: May 10, 2022
Description: How have you impacted someones life today? At
Hackensack Meridian Health our healthcare teams are focused on
changing the lives of our patients by providing the highest level
of care each and every day. From our hospitals, rehab centers and
occupational health teams to our long-term care centers and at-home
care capabilities, our complete spectrum of services will allow you
to apply your skills in multiple settings while building your
career all within New Jerseys premier healthcare system.The
Reimbursement Analyst III position provides specialized,
senior-level technical and analytical support for all aspects
within the reimbursement department for the Hackensack Meridian
Health (HMH) Network. Work assignments are complex and require
in-depth knowledge of governmental reimbursement, possessing strong
analytical and investigative skills. This position will guide and
coordinate direction on reimbursement matters, including
preparation of advanced sections of the Medicare and NJDOH cost
reports, completion of advanced reimbursement studies and models
(PPS Rate calculations, IME/GME, APC Rate calculations, etc.), and
audit coordination. In addition, coordinates strategic modeling,
appeal development and tracking. Will also coordinate the
completion of cost reports for a dedicated region.This position
will be hybrid- required to be in office 1 day per week, work
remotely the other 4 daysResponsibilties: A day in the life of a
Reimbursement Specialist III at Hackensack Meridian Health
- Keeps fully informed of current and anticipated changes in
Medicare and Medicaid hospital and professional reimbursement
determining the impact on the Network's entities.
- Summarizes final regulations with applicable financial impacts
and distributes them to key internal stakeholders across the
- Prepares written comments on proposed regulatory changes and
submits them to CMS and Medicaid ensuring that the Network's voice
is heard by regulators.
- Organizes and coordinates potential revenue enhancement
opportunities to optimize reimbursement including but not limited
- combining provider numbers; Medicare wage index;
disproportionate share; charity care subsidy; medical education;
organ transplantation; and Medicare Bad Debts.
- Researches potential governmental appeals to file. Files and
tracks appeals filed.
- Supports the coordination and filing of the Corporate Cost
- Preparation of the Medicare, Chapter 160 and Champus cost
reports for hospitals including advanced worksheets.
- Coordination and accumulation of information needed for the
Home Health Agency and Home Office cost reports as needed.
- Coordination and accumulation of statistical data as
- Coordination and accumulation, as needed, of Interns &
Residents schedules and all required personal data including
preparation of the IRIS.
- Coordination and support of the Wage Index submission to CMS
including acting as the point person for the Wage Index
- Completion of the NJ DSH and Occupational Mix Surveys.
- Coordinating any bad debt audits by effectively working with
- Support various Medicare and Medicaid appeals including
gathering of required supporting documentation and insuring timely
- Research, coordination and completion of various CMS and Molina
applications such as 855s and IME/GME Resident Cap Increase
- Assist with assuring Medicare and Medicaid rates are correctly
reported in the system.
- Completion of Psychiatry PPS Exclusion analysis.
- Research as needed via Internet, relevant publications,
reimbursement manuals, etc. to ensure compliance and maximize
reimbursement strategies within regulations.
- Coordinate and support Medicare and Medicaid audits, including
acting as the point person.
- Review of audit adjustments including effective communication
with outside auditors in resolving any issues as needed.
- Software input of the cost report data as needed.
- Monthly review of third party accounts of HMH hospitals.
- Special projects and other duties as assigned by
- Adheres to HMH Organizational competencies and standards of
behavior.Qualifications: Education, Knowledge, Skills and Abilities
- Bachelor's degree in Accounting/Finance or related field.
- Minimum of 5 or more years of progressive reimbursement related
experience in consulting and/or in a large health network and/or
academic medical center.
- Advanced proficiency in using technology including but not
limited to Microsoft Office (Excel, Outlook, etc.).
- Proven record of progressive professional growth and
- Excellent written and verbal communication skills.
- Excellent analytical skills including ability to complete
detailed work papers for an audit trail.
- Effective written and verbal communication skills.
- Ability to establish effective working relationships with all
levels of the Hackensack Meridian Health organization as needed.
Licenses and Certifications Preferred:
- Certified Public Accountant (CPA) and/or Masters of Business
- Governmental Audit experience.If you feel that the above
description speaks directly to your strengths and capabilities,
then please apply today!by Jobble
Keywords: Hackensack Meridian Health, Hackensack , Reimbursement Specialist III, Accounting, Auditing , Hackensack, New Jersey
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