[Hiring] Reimbursement Manager @Lehigh Valley Health Network

Role Description

Interprets Medicare and Medicaid regulation and directs hospital activities to comply with government payment regulation and optimize Medicare and Medicaid revenue. Develops and executes processes necessary to gather information required for completion of the Medicare and Medicaid cost reports and is responsible to complete the cost reports accurately and by the filing due dates.

• Calculates the financial impacts of purchasing, readmissions, hospital acquired infections, and accountable care arrangements.
• Develops strategies and implements processes to ensure the hospital is in compliance with Medicare and Medicaid regulation.
• Develops processes needed to complete cost reports and ensure the hospital is paid for all programs and services.
• Provides expert guidance on complying with Medicare and Medicaid reimbursement and payment regulation.
• Provides expert advice to identify opportunities to achieve reimbursement for all programs and services provided.
• Provides support for participation in cost report appeals and cost report group appeals.
• Evaluates firms organizing group appeals and recommends firms and consultants to use in preparing and following appeals.
• Supports the revenue budget process for items where reimbursement is calculated on the cost report.
• Reviews third party settlements monthly and updates in accordance with the monthly and fiscal year end closing schedules.

Qualifications

• Bachelor’s Degree
• 5 years interpreting Medicare and Medicaid payment regulation and completing Medicare and Medicaid cost reports.
• 5 years recording revenue and determining cost settlement receivables/payables for Medicare and Medicaid payments.
• Ability to work independently.

Requirements

• Lift and carry 25 lbs.
• Frequent sitting/standing.
• Frequent keyboard use.
• Patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting, and performing CPR.

Company Description

Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy.

• Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities.