Manager Reimbursement

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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
Oversees Medicare and Medicaid cost reports submitted system wide to obtain appropriate reimbursement from these programs and monitor hospitals' compliance with internal reimbursement policies and procedures. Interprets Medicare and Medicaid regulations and directs hospital activities to comply with government payment regulations. Critically reviews proposed adjustments to cost reports and assists the Director and Vice President decide which adjustments should be appealed.

Job Duties
- Develops processes needed to complete cost reports and ensure payments for all programs and services.

- Develops strategies and implement processes to ensure the hospitals are in compliance with Medicare and Medicaid regulation.

- Responsible for the accuracy of system wide Medicare and Medicaid cost report submissions.

- Provides expert guidance on complying with Medicare and Medicaid reimbursement and payment regulation.

- Identifies opportunities to achieve reimbursement for all programs and services provided.

- Participates in cost report appeals and cost report group 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 closing schedules.

- Oversees hiring, training and colleague performance.

- Periodically visit hospitals to assure compliance with cost reporting data collection requirements and address questions or operational challenges.

Minimum Qualifications
- Bachelor’s Degree in Accounting, Finance, or related field

- 5 years experience interpreting Medicare and Medicaid payment regulation and completing Medicare and Medicaid cost reports and

- 5 years experience recording revenue and determining cost settlement receivables/payables for Medicare and Medicaid payments and

- 3 years in a hospital/acute care environment

- High-level of MS Office skills needed

- Able to train staff in technology and hospital reimbursement issues

- Ability to work in a fast paced environment

- Able to review large amount of data

- Ability to work independently

Preferred Qualifications - Master’s Degree in Accounting, Finance, or related field

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 respon