Reimbursement Specialist III
Company: Hackensack University Medical Center
Location: Hackensack
Posted on: May 14, 2022
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Job Description:
Overview 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 days Responsibilities A day in the life of a
Reimbursement Specialist III at Hackensack Meridian Health
includes: Keeps fully informed of current and anticipated changes
in Medicare and Medicaid hospital and professional reimbursement
determining the impact on the Networks entities. Summarizes final
regulations with applicable financial impacts and distributes them
to key internal stakeholders across the Network. Prepares written
comments on proposed regulatory changes and submits them to CMS and
Medicaid ensuring that the Networks voice is heard by regulators.
Organizes and coordinates potential revenue enhancement
opportunities to optimize reimbursement including but not limited
to: 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 Report.
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 needed. 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 audits. Completion of the NJ DSH and
Occupational Mix Surveys. Coordinating any bad debt audits by
effectively working with Patient Accounting. Support various
Medicare and Medicaid appeals including gathering of required
supporting documentation and insuring timely submissions. Research,
coordination and completion of various CMS and Molina applications
such as 855s and IME/GME Resident Cap Increase applications. 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 Management. Adheres to HMH Organizational competencies
and standards of behavior. Qualifications Education, Knowledge,
Skills and Abilities Required: Bachelors 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 responsibility. 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 Administration (MBA). Governmental
Audit experience. If you feel that the above description speaks
directly to your strengths and capabilities, then please apply
today! Our Network Hackensack Meridian Health (HMH) is a Mandatory
COVID-19 and Influenza Vaccination Facility As a courtesy to assist
you in your job search, we would like to send your resume to other
areas of our Hackensack Meridian Health network who may have
current openings that fit your skills and experience.
Keywords: Hackensack University Medical Center, Hackensack , Reimbursement Specialist III, Accounting, Auditing , Hackensack, New Jersey
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