Talent.com
Reimbursement Manager

Reimbursement Manager

Inova Health SystemFairfax, VA, United States
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
  • serp_jobs.job_card.temporary
job_description.job_card.job_description

Inova Health is looking for a dedicated Reimbursement Manager to join the team, this role will be full-time day shift Monday-Friday, 8 : 00 a.m.- 5 : 00 p.m., Remote

The Reimbursement Manager develops, prepares, and presents the financial impact of all new and proposed Medicare / Medicaid regulations to senior management. Directs the development of contractual allowances for budget projections. Takes ownership of Graduate Medical Education and Indirect Graduate Medical Education reimbursement. Manages, directs, and assists in the preparation and / or review of preliminary and filed Medicare / Medicaid cost reports. Manages daily operations of the reimbursement group, including staff assignments and prioritization of projects. Stays abreast of Medicare / Medicaid regulations and works to ensure that Inova Health System's facilities stay in compliance with regulations within the scope of assigned duties.

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.

Featured Benefits :

  • Committed to Team Member Health : offering medical, dental and vision coverage, and a robust team member wellness program.
  • Retirement : Inova matches the first 5% of eligible contributions - starting on your first day.
  • Tuition and Student Loan Assistance : offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
  • Mental Health Support : offering all Inova team members, their spouses / partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
  • Work / Life Balance : offering paid time off, paid parental leave, and flexible work schedules.

Reimbursement Manager Job Responsibilities

  • Directs the preparation of reimbursement studies as needed by senior management.
  • Researches regulations related to the implementation of new programs, services, and ventures.
  • Researches regulations for developing techniques for maximizing reimbursement.
  • Prepares and coordinates the necessary journal entries and explanations for monthly processing.
  • Directs the evaluation of interim payments from third-party payers for accuracy and adequate cash flow.
  • Coordinates with Information Systems regarding the production of reports for cost reporting / analysis purposes.
  • Reviews Generally Accepted Accounting Principles and auditing standards as they apply to the reimbursement area.
  • Develops and conducts reimbursement seminars for the staff of Health Information Systems (HIS) operating units.
  • Prepares work papers for the Home Office cost statement and defends them when audited.
  • Takes ownership of Graduate Medical Education (GME) and Indirect Graduate Medical Education (IGME) reimbursement. Stays abreast of all Centers for Medicare & Medicaid Services regulatory changes that impact GME / IGME reimbursement.
  • Works with the GME Office to maintain documentation on the GME Program to support cost reports.
  • Completes the IRIS report for submission to Medicare annually.
  • Prepares Home Office work papers and Home Office cost statements for submission to Medicare and Medicaid.
  • Reviews Medicare / Medicaid settlements for accuracy and impact on reimbursement for all HIS entities.
  • Takes ownership of the appeal of cost reports. Prepares position papers for filing with the Provider Reimbursement Review Board.
  • Work with the GME Office to maintain the necessary documentation to count residents for GME / IGME reimbursement.
  • Stays abreast of GME / IGME regulations. Reviews filed cost reports for accuracy and reasonableness while performing analysis of trends as appropriate.
  • Reviews final settled cost reports to determine if the next steps are appropriate.
  • Prepares position papers for Medicare / Medicaid appeals including responses to the Medicare Fiscal Intermediary.
  • Documents and defends adequacy of reserves for all open Medicare / Medicaid cost reports.
  • Reviews and maintains processes for completion of required documentation to support the ability to claim accurate reimbursement in the areas of wage index, DSH, and bad debts.
  • Maintains knowledge of changing regulations through such means as reading needed regulations, newsletters, and continuing education workshops.
  • Oversees assigned department or functional area to ensure it is performing effectively, which may include but not limited to, hiring and training team members, creating and implementing business strategies, managing performance of team members, and delegating tasks.
  • May perform additional duties as assigned.
  • Minimum Qualifications

    Experience - Seven years of reimbursement experience in a healthcare setting to include at least two years in a management position.

    Education - Bachelors Degree in Business Administration or Accounting.

    Preferred Qualifications

    End-to-End Medicare cost reporting : Expertise including preparation, amendments, reopening's, settlements, and audit / appeals interaction.

    Amendments & Appeals : Identifies amendment opportunities; manages appeal timelines; documents and defends reserves on open reports; prepares the monthly journal entries for the cost report reserves.

    Audits & Interaction : Direct experience collaborating with Medicare auditors, including issue resolution, audit responses, and negotiating findings.

    Vendor Coordination : Manages external reimbursement vendors (scope definition, data exchanges, and QA of workpapers / deliverables).

    Provider Enrollment : Hands-on with Medicare provider enrollment, modifications, revalidations, and coordination to secure timely effective dates aligned to cost reporting would be a plus.

    Remote Eligibility : This position is eligible for remote work for candidates residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV

    serp_jobs.job_alerts.create_a_job

    Reimbursement Manager • Fairfax, VA, United States

    Job_description.internal_linking.related_jobs
    • serp_jobs.job_card.promoted
    Compliance - Healthcare Risk Management Program Manager (O-5 Billet) Non-Supervisory

    Compliance - Healthcare Risk Management Program Manager (O-5 Billet) Non-Supervisory

    US Government JobsWashington, DC, US
    serp_jobs.job_card.full_time
    Compliance - Healthcare Risk Management Program Manager.The Compliance - Healthcare Risk Management Program Manager oversees risk management within ICE / IHSC, focusing on preventing, reducing, and c...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Manager, Operations Enablement

    Manager, Operations Enablement

    Strive HealthWashington, DC, US
    serp_jobs.job_card.full_time
    Manager, Operations Enablement.At Strive Health, we're driven by a purpose : transforming the broken kidney care system.Through early identification, engagement, and comprehensive coordinated care, ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    RN Clinical Manager

    RN Clinical Manager

    Monocacy Surgery Center (11305)FREDERICK, Maryland, United States
    serp_jobs.job_card.full_time
    Monocacy Surgery Center is hiring a full time RN Clinical Manager.The RN Clinical Manager directs, coordinates and controls the multi-disciplinary activities for patients undergoing surgical interv...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_hour
    • serp_jobs.job_card.promoted
    Manager / Senior Manager - Market Access & Reimbursement

    Manager / Senior Manager - Market Access & Reimbursement

    ConvaTecWashington, DC, US
    serp_jobs.job_card.full_time
    Senior Manager Market Access & Reimbursement.Pioneering trusted medical solutions to improve the lives we touch : Convatec is a global medical products and technologies company, focused on solutions...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Manager, Enterprise Performance

    Manager, Enterprise Performance

    Strive HealthWashington, DC, US
    serp_jobs.job_card.full_time
    Manager, Enterprise Performance.At Strive Health, we're driven by a purpose : transforming the broken kidney care system. Through early identification, engagement, and comprehensive coordinated care,...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Medical Director

    Medical Director

    National Veterinary AssociatesPurcellville, VA, US
    serp_jobs.job_card.full_time
    Blue Ridge Veterinary Associates.Imagine leading a practice where\nyour team saves wildlife before breakfast, performs complex surgeries by\nafternoon, and mentors the next generation of veterinari...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    Medical Reimbursement Analyst

    Medical Reimbursement Analyst

    Sparks GroupDulles, Virginia, United States
    serp_jobs.job_card.temporary
    serp_jobs.filters_job_card.quick_apply
    Sparks Group has partnered with a leader in healthcare services that has an immediate need for experienced Medical Reimbursement Analysts for a 5 month contract. Position is on site in Serling, VA p...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    Authorization Specialist / Case Manager

    Authorization Specialist / Case Manager

    MediabistroWashington, DC, United States
    serp_jobs.job_card.full_time
    Authorization Specialist / Case Manager.Monday–Friday, 8 : 00 AM–4 : 30 PM (flexible start time available).Serve as a liaison between patients, insurance companies, and clinical staff.Manage and follow u...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Program Manager III, Medicare Risk Adjustment & Chart Review

    Program Manager III, Medicare Risk Adjustment & Chart Review

    Kaiser PermanenteRockville, MD, US
    serp_jobs.job_card.full_time
    Program Manager III, Medicare Risk Adjustment & Chart Review.The Program Manager III for Risk Adjustment and Chart Review is responsible for overseeing the accuracy and efficiency of risk adjustmen...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Travel Nuclear Medicine Technologist

    Travel Nuclear Medicine Technologist

    Nightingale NursesLeesburg, VA, US
    serp_jobs.job_card.full_time
    Nightingale Nurses is seeking a travel Nuclear Medicine Technologist for a travel job in Leesburg, Virginia.Job Description & Requirements. You may not realize it, but as an RN with real world h...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    FRM, Field Reimbursement Manager, Various

    FRM, Field Reimbursement Manager, Various

    RemX | The Workforce ExpertsWashington, DC, US
    serp_jobs.job_card.full_time
    The Washington DC territory includes (DC, Baltimore, Columbia, Rockville, Annapolis, an Nova down to Norfolk) The northern part of this territory pay ranges from $116K-121K (plus bonus, base pay de...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Reimbursement Specialist

    Reimbursement Specialist

    Amergis Healthcare StaffingColumbia, MD, US
    serp_jobs.job_card.full_time
    The Reimbursement Specialist I reviews branch sales for appropriate documentation, generate and bill claims and / or invoices, follows up on unpaid accounts, and provides support and customer service...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Director, Capabilities - Access & Reimbursement - US Remote

    Director, Capabilities - Access & Reimbursement - US Remote

    Initial Therapeutics, Inc.Washington, DC, United States
    serp_jobs.filters.remote
    serp_jobs.job_card.full_time
    Join Amgen's Mission of Serving Patients.At Amgen, if you feel like you're part of something bigger, it's because you are. Our shared mission to serve patients living with serious illnesses drives a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Senior Clinical Risk Manager

    Senior Clinical Risk Manager

    Mount Sinai HospitalWashington, DC, US
    serp_jobs.job_card.full_time
    The Senior Clinical Risk Manager serves as a resource to staff to enhance patient safety, promote quality of care, and minimize loss to protect the assets of the facility.The Senior Risk Manager su...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Senior Manager, Program Integrity (CPC, RHIT or RHIA is required)

    Senior Manager, Program Integrity (CPC, RHIT or RHIA is required)

    JobgetherWashington, DC, US
    serp_jobs.job_card.full_time
    Senior Manager, Program Integrity.This position is posted by Jobgether on behalf of a partner company.We are currently looking for a Senior Manager, Program Integrity (CPC, RHIT or RHIA required) i...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Refund Specialist

    Refund Specialist

    Zotec PartnersFrederick, MD, US
    serp_jobs.job_card.full_time
    At Zotec Partners, our people make it happen.Transforming the healthcare industry isn't easy.But when you build a team like the one we have, that goal can become a reality.Our accomplishments can't...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Reimbursement Business Manager-Immunology-Arlington, VA & Bethesda, MD

    Reimbursement Business Manager-Immunology-Arlington, VA & Bethesda, MD

    RegeneronBethesda, MD, US
    serp_jobs.job_card.full_time
    The Field Access & Reimbursement environment for specialty biologics has proven to be highly challenging for HCPs and Patients. Payer Formularies and restrictive Utilization Management Criteria incl...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    RCM Manager

    RCM Manager

    Carda HealthWashington, DC, US
    serp_jobs.job_card.full_time
    Carda Health RCM Manager Opportunity.So much so that only 10% of qualifying heart patients attend, which results in complications for patients and at least $190B in excess costs.At Carda Health, we...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Compensation Manager

    Compensation Manager

    Association of American Medical CollegesWashington, DC, US
    serp_jobs.job_card.full_time
    The Association of American Medical Colleges is a not-for-profit association dedicated to transforming health care by supporting the entire spectrum of medical education, medical research, and pati...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Director of Medical Support-RN (Nurse Manager)

    Director of Medical Support-RN (Nurse Manager)

    Patient FirstCapitol Heights, MD, US
    serp_jobs.job_card.full_time
    The responsibilities of this job include, but are not limited to, the following : .Managing the overall operation of the center under the supervision of the Medical Director;.Ensuring center staff fo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days