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Sr Reimbursement Specialist

Company: Mercy
Location: Saint Louis
Posted on: April 18, 2019

Job Description:

We're a Little Different

Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.

We don't believe in jobs at Mercy, we believe in careers that match the unique gifts of unique individuals; careers that not only make the most of your skills and talents, but also your heart.

At Mercy, you'll feel our supportive community every step of your day, especially the tough ones. We're a team and love working that way. That team is expanding, and we currently have exceptional opportunities to help our communities grow.

Individual will be responsible for various functions necessary to ensure accurate reimbursement for one or more hospitals, rural health clinics, home health services or other healthcare entities within Mercy. Functions include but are not limited to gathering and preparing data necessary for filing all Medicare and Medicaid cost reports; coordinating all audit activities that relate to third party issues; analyzing, preparing, and booking the monthly third-party activity; coordinating provider enrollment issues related to the 855 process; supporting compliance-related projects as necessary; supporting financial analysis requests; and, preparing various industry and payer surveys. Must be highly ethical, and morally committed to adherence to all applicable laws and regulations. Performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.

Cost Report Preparation

* Prepare cost reimbursement reports, or sections thereof, for government and third party agencies, as assigned

* Collection of data necessary to prepare the annual cost report

* Prepare interim cost reports when assigned

Month End Process

* Provide reports and other data needed for month end process

* Prepare month end calculations for 3rd party, AR or others as assigned

* Monitor Medicare and Medicaid rate tables in EPIC/3M to ensure proper posting

* Monitor Lawson GL accounts related to calculations to ensure proper posting of items

* Assist with net revenue budgets as assigned

Audit Support

* Coordinate or assist with intermediary audits of cost reports

* Provide data necessary and assist consultants with wage index audits

* Provide data necessary and assist with State Medicaid DSH audits

* Assist with EHR audits and other inquires as assigned

* Visit new acquisition HOD sites to make sure all provider based regulations are met.

* Assist/coordinate making the HOD sites compliant as necessary.

855 Process

* Assist/train new employees on the filing of the 855's and other government payors to ensure accuracy

* File CHOW 855's for new acquisitions

* Make sure all providers remain active by making sure revalidations are completed on time and keeping in contact with the MAC's when needed.

* Attend all acquisition and construction meetings to ensure 855 and HOD issues are addressed promptly and correctly.

Banking Changes

* Coordinate or assist with banking changes for all government payors

* Provide assistance/coordinate lockbox changes for all government payors.

Other Responsibilities

* Reviewed proposed and final regulations as well as publications and other sources to stay on top of changes to reimbursement

* Perform Ad-Hoc analysis for financial leadership as requested

* Performs other work duties as assigned

QUALIFICATIONS:

Because you're committed to excellence, you understand the importance of being properly prepared for your role at Mercy. That's why you'll bring to your role the right set of qualifications:

Minimum Required Qualifications

Education:

BS Degree in Accounting or Finance

Experience:

5 years experience in healthcare cost reporting

Other Skills and Knowledge:

Proficiency in Microsoft Office applications

Verbal communication skills

Preferred Qualifications

Licensure:

CPA or other is a plus

Experience:

5+ yrs in Medicare cost report preparation or auditing

Medicare Area Contractor experience is a plus

Certification/Registration:

CPA or other is a plus

Other Skills and Knowledge:

Access and other database software experience

Lawson GL experience

We'll Support You at Work and Home

Our foundations are built on dignity and respect. Modern Healthcare Magazine named us as a "top 100 places to work." We go out of our way to help people feel welcomed. We offer day-one comprehensive health, vision and dental coverage, PTO, and employer-matched retirement funds, even to part-time employees. We're proud to provide tuition reimbursement to help you grow and learn new skills.

What Makes a Good Match for Mercy

Compassion and professionalism go hand-in-hand with us, along with exceptional quality care. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We're also collaborative and are not afraid to do a little extra to deliver excellent care - that's just part of our commitment. If that sounds like a fit for you as well, we encourage you to apply.

#LI-BM1.

EEO/AA/Minorities/Females/Disabled/Veterans

Keywords: Mercy, St. Louis , Sr Reimbursement Specialist, Accounting, Auditing , Saint Louis, Missouri

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