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Reimbursement Specialist II @Broadway Ventures

[Hiring] Reimbursement Specialist II @Broadway Ventures

Feb 11, 2025 - Broadway Ventures is hiring a remote Reimbursement Specialist II. 💸 Salary: unspecified. 📍Location: USA.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

The Reimbursement Specialist II is responsible for managing, analyzing, and ensuring the accuracy and timeliness of Medicare cost report acceptance, settlements, interim rates, and applicable limits for healthcare providers within the Fiscal Intermediary Shared Systems (FISS). This role plays a critical part in ensuring proper reimbursement and compliance with Medicare regulations while working closely with internal teams and external stakeholders.

Key Responsibilities:

  • Cost Report & Reimbursement Analysis:
    • Conduct in-depth analysis of Medicare cost reports to complete tentative and straight-to-final settlements and rate reviews.
    • Evaluate payment rates for PPS providers receiving pass-through payments, RHC per-visit limits, and per diem rates for cost-reimbursed providers.
    • Review and validate financial documents, including system-generated reports, provider-submitted work papers, PS&R reports, and lump sum data.
  • Regulatory Compliance & System Updates:
    • Ensure compliance with CMS (Centers for Medicare & Medicaid Services) regulations, monitoring CMS directives (TDLs, CRs, and other official guidance) to implement necessary updates.
    • Review and process status changes for Sole Community Hospitals, rural reclassifications, and rural referral centers.
    • Work closely with CMS and internal teams to submit and recommend accelerated payment requests for providers facing financial hardships.
  • Operational Management & Process Improvement:
    • Track and prioritize provider-requested reviews outside of normal workload cycles.
    • Maintain and update internal workflow processes, system configurations, and procedural documentation in response to CMS requirements.
    • Analyze and address discrepancies in workload reports, ensuring timely completion of daily and monthly tasks.
  • Collaboration & Training:
    • Work closely with internal teams, including Reimbursement Staff, Supervisors, and Managers, to coordinate CMS correspondence and regulatory updates.
    • Provide mentorship and training on specialized reimbursement functions and system usage.
    • Develop and deliver training programs to enhance team expertise in cost report processing and enrollment updates.

Qualifications

  • Associate’s degree in Accounting, Business, or a related field.
  • 3+ years of experience in Medicare cost report processing, reimbursement functions, enrollment updates, and provider payments.
  • Strong analytical skills with exceptional attention to detail and a high level of accuracy.
  • Ability to interpret and apply Medicare regulations and reimbursement principles.
  • Critical thinking and problem-solving abilities in a healthcare reimbursement setting.
  • Proficiency in Microsoft Office Suite (Excel, Word, Access, PowerPoint) and data analysis tools.

Requirements

  • Bachelor’s degree in Accounting, Business, Healthcare Administration, or a related field.
  • Medicare Cost Reporting experience, with advanced knowledge of Medicare Cost Reporting systems, FISS, Higlas, STAR, and WPM.
  • 2+ years of experience in accounting or healthcare reimbursement.
  • Excellent time management, organizational, and customer service skills.

Benefits

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Medical insurance
  • Life insurance
  • Flexible Paid time off (F PTO)
  • Paid Holidays

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📍 Be aware of the location restriction for this remote position: USA
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Back to Remote jobs  >   All others
Reimbursement Specialist II @Broadway Ventures
All others
Salary 💸 unspecified
Remote Location
USA
Job Type full-time
Posted Feb 11, 2025
Apply for this position Unlock 54,958 Remote Jobs
️
📍 Be aware of the location restriction for this remote position: USA
‼ Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.
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