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Reimbursement Manager
Lehigh Valley Health Network. Interpret Medicare and Medicaid regulation and direct hospital activities to comply with government payment regulation and optimize Medicare and Medicaid revenue .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Expertise in Medicare and Medicaid regulation compliance, cost report preparation, and reimbursement strategies is essential. Strong analytical skills for evaluating financial impacts and supporting revenue budget processes are critical.
Highest-signal resume keywords
Medicare Regulation InterpretationMedicaid Regulation InterpretationCost Report PreparationRevenue Budget SupportFinancial Impact Analysis
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Cost ReportingFinancial AnalysisReimbursement StrategiesRegulatory ComplianceData Gathering ProcessesRevenue RecordingSettlement Receivables ManagementAppeals SupportHospital Acquired Infections AnalysisAccountable Care Arrangements
Soft Skills
Independent WorkAnalytical Thinking
Certifications & Qualifications
Bachelor's Degree
Industry Keywords
MedicareMedicaidGovernment Payment RegulationCost ReportsReimbursementFinancial ImpactsCost SettlementThird-Party SettlementsGroup AppealsConsultant Evaluation
About the role
Key responsibilities & impact- Interpret Medicare and Medicaid regulation and direct hospital activities to comply with government payment regulation and optimize Medicare and Medicaid revenue
- Develop and execute processes to gather information required for Medicare and Medicaid cost reports
- Complete cost reports accurately and by filing due dates
- Calculate financial impacts of purchasing, readmissions, hospital acquired infections, and accountable care arrangements
- Develop strategies and implement processes to ensure hospital compliance with Medicare and Medicaid regulation
- Develop processes needed to complete cost reports and ensure payment for all programs and services
- Provide expert guidance on Medicare and Medicaid reimbursement and payment regulation
- Identify opportunities to achieve reimbursement for all programs and services provided
- Support participation in cost report appeals and cost report group appeals
- Evaluate firms organizing group appeals and recommend firms and consultants for preparing and following appeals
- Support the revenue budget process for items where reimbursement is calculated on the cost report
- Review third-party settlements monthly and update them according to monthly and fiscal year-end closing schedules
Requirements
What you’ll need- 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
- Ability to lift and carry 25 lbs.
- Frequent sitting/standing
- Frequent keyboard use
Benefits
Comp & perks- Equal opportunity employment
- Day shift schedule
- Monday-Friday 8:00A-4:30P
- Remote work in Pennsylvania