报销经理
Reimbursement Manager
在国家最先进的医疗网络之一开启你的职业生涯。
成为卓越医疗体验的一部分。加入莱茵兰山谷医疗网络（Lehigh Valley Health Network）充满激情和使命感的团队，这是一家全国知名的、具有前瞻性的组织，提供大量机会去做出出色的工作。
LVHN连续23年被《美国新闻与世界报道》（U.S. News & World Report）评为“最佳医院”。我们是Magnet(tm)医院，曾五次获得美国护士认证中心（American Nurses Credentialing Center）授予的杰出护理成就和优质患者结果的荣誉，这是我们在莱茵兰山谷地区获得的殊荣。最后，莱茵兰山谷医院- Cedar Crest、莱茵兰山谷医院- Muhlenberg、莱茵兰山谷医院- Hazleton 和莱茵兰山谷医院- Pocono 在2020年获得了Leapfrog Group的医院安全评分中的“A”等级，这是患者安全方面的最高评分。这些荣誉突显了LVHN对团队合作、同理心和技术的承诺，并始终专注于每天提供最佳的医疗服务。
无论你是在考虑下一次职业转变还是第一次工作，都应该考虑莱茵兰山谷医疗网络。
简介
解读医疗保险和医疗补助法规，指导医院活动以符合政府支付法规并优化医疗保险和医疗补助收入。制定并执行必要的流程，收集完成医疗保险和医疗补助成本报告所需的信息，并负责准确且按时完成成本报告。
职位职责
· 计算采购、再入院、医院获得性感染和责任医疗安排的财务影响。
- 制定策略并实施流程，确保医院符合医疗保险和医疗补助法规。
- 制定完成成本报告所需的流程，并确保医院获得所有项目和服务的付款。
- 提供关于遵守医疗保险和医疗补助报销和支付法规的专业指导。
- 提供专业建议，以识别实现所有项目和服务报销的机会。
- 为参与成本报告上诉和成本报告小组上诉提供支持。
- 评估组织小组上诉的公司，并推荐用于准备和跟进上诉的公司和顾问。
- 支持成本报告中计算的报销项目的收入预算流程。
- 审核第三方
查看英文原文
Imagine a career at one of the nation's most advanced health networks.
Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work.
LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day.
Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network.
Summary
Interprets Medicare and Medicaid regulation and direct 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.
Job Duties
· Calculates the financial impacts of purchasing, readmissions, hospital acquired infections, and accountable care arrangements.
- Develops strategies and implement 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 recommend firms and consultants to use in preparing and follow 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.
Minimum Qualifications
· Bachelor’s Degree
- 5 years Interpreting Medicare and Medicaid payment regulation and completing Medicare and Medicaid cost reports. and
- 5 years Recording revenue and determining cost settlement receivables/payables for Medicare and Medicaid payments
- Ability to work independently.
Physical Demands
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.
Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.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.
Lehigh Valley Health Network does not accept unsolicited agency resumes. Agencies should not forward resumes to our job aliases, our employees or any other organization location. Lehigh Valley Health Network is not responsible for any agency fees related to unsolicited resumes.
Work Shift:
Day ShiftAddress:
1200 S Cedar Crest BlvdPrimary Location:
REMOTE IN PENNSYLVANIAPosition Type:
RemoteUnion:
Not ApplicableWork Schedule:
Monday-Friday 8:00A-4:30PDepartment:
1004-13115 CSS-FinanceOriginally posted on Himalayas