Reimbursement Specialist

The main responsibility is the preparation of the Medicare, Medicaid, and TRICARE reports for Tenet acute care hospitals (“Cost Reports”). The position also coordinates with the Government Programs Audit Support and Operations Reimbursement to resolve audit issues and reimbursement matters, respectively.

Required

• Individual must be fully versed in principles of reimbursement, keep current on legislative changes, and be fully versed in cost report preparation.
• Individual must be capable of handling multiple projects and must be able to provide technical support to the hospitals, regions, and corporate.
• Bachelor’s degree in Accounting/Business
• Minimum 1-2 years’ experience in Medicare and/or Medicaid reimbursement.
• Prefer at least some cost report preparation experience.
• Responsible for the accurate completion, review, and on time filing of all Medicare and Medicaid cost reports to obtain appropriate reimbursement from these programs and monitor our hospitals compliance with the company’s reimbursement policies and procedures.
• Prepare all required Medicaid Supplemental reports and Tricare Capital/DME Reimbursement reports to procure all amounts due from these government programs as applicable for our hospitals.
• Be familiar with CMS regulations surrounding the rules and instructions for reimbursement through a Medicare cost report (PRM 15-1 and 15-2 and CFR Part 412) and stay abreast of changes and updates to these rules and regulations throughout the year as they are released.
• Work closely alongside hospitals to ensure all data provided in the cost report package is complete and correct.
• Communicate with the hospital Controllers, CFOs and GBC staff to resolve all outstanding questions or missing information.
• Document and support material changes from prior year to current year amounts as needed.
• Prepare and maintain various data elements required for cost report analysis such as square feet statistics, current year to prior year trend reports, and queries.
• Document and support material and process changes as needed.
• Compose audit workpapers and gather backing documents necessary so that audit staff are prepared for all CMS Medicare and Medicaid audits and cost report amounts reported are thoroughly supported.
• Explain any material variances in costs, charges, or manners of reporting as they arise.
• Aid with special projects as needed such as updates/revisions to cost report package schedules and investigate/review any new reporting requirements issued by CMS pertaining to Medicare and Medicaid reports.
• Review prior year audit findings and adjustment reports and incorporate any changes necessary into the preparation of the current year report.
  
  

Tenet Healthcare complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.

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Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.