Reimbursement Specialist

To perform the functions of contractual allowances reimbursement cost reporting revenue budgeting and special projects. To implement changes resulting from research of laws and regulations issued by Medicare Medicaid and other third party payers. To prepare monthly analyses related to allowances for contractual adjustments and bad debts as well as cost report settlements receivable (payable). To prepare annual cost reports and be point of contact for intermediary audits reviews and appeals. To implement rate optimization analyses and changes. To closely interact with Director of Reimbursement on reimbursement budget and cost issues.

• Determines transactions related to third-party reimbursement including contractual adjustments settlements receivable (payable) Medicare and Medicaid Cost Reports appeals amendments and re-openings.
• Maintains competency in reimbursement by keeping knowledge of current developments at the State and Federal level and through continuing education.
• Performs or assists with profitability studiesrate optimization and strategic pricing revenue volume and cost projections financial feasibility studies trend analysis and other decision support projects and reports.
• Participates in design and planning of Hospital budgetrelating to rate setting and contractual adjustments.
• Implements appropriate reporting mechanisms in conjunction with Director of Reimbursement.
• Ensures reimbursement optimal rates and codes are implemented and communicated to the departmentsand helps the charge master analysts in the establishment of all hospital services rates.
• Works in conjunction with Patient Accounting staff to determine and resolve potential patient claim underpayments identified by PCON software.
• Evaluates participating provider agreements and produces financial models for proposed agreements.
• Meets all departmental specific competencies.
• Adheres to medical center policies addressing infection control safety and personnel guidelines.
• Demonstrates knowledge of and compliance with the hospital code of conduct and applicable corporate policies and procedures.
• Maintains patient confidentiality and treats patients and their families with respect and dignity.
• In addition to the above job responsibilities, other duties may be assigned.
  

Position Compensation Range: $67,849.60 - $108,555.20 Annual

MINIMUM REQUIREMENTS

Education: Bachelor’s Degree in Business Finance or related field is required.

Experience: 3 years’ experience in Finance required.

Licensure: Certified Public Accountant Fellow HFMA (FHFMA) preferred. Expereince utilizing Siemen's preferred.

PHYSICAL DEMANDS

Job requires sitting for prolonged periods. Proficient communicative, auditory and visual skills; Attention to detail and ability to write legibly.

The University of Virginia, i ncluding the UVA Health System which represents the UVA Medical Center, Schools of Medicine and Nursing, UVA Physician’s Group and the Claude Moore Health Sciences Library, are fundamentally committed to the diversity of our faculty and staff. We believe diversity is excellence expressing itself through every person's perspectives and lived experiences. We are equal opportunity and affirmative action employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.