Talent.com
Cost Report Reimbursement Manager

Cost Report Reimbursement Manager

Avera HealthSioux Falls, SD, US
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

Cost Report Reimbursement Manager

The Cost Report Reimbursement Manager will be responsible for the oversight of reimbursement associated with the Medicare, Medicaid, Tricare and any other governmental cost reports and regulatory support for Avera Health hospitals, clinics, home healths, hospices, and nursing homes. Oversight includes the Medicare, Medicaid and Tricare cost reports for all entities in the Avera system.

What you will do :

  • Accountable to the completion of the monthly Medicare 3rd Party Settlement calculation for all hospitals.
  • Assist in the development and calculations of the annual revenue deductions and uncompensated care budget for all Avera hospitals, clinics, and nursing.
  • Manage and maintain workflows for filing and review of Medicare, Medicaid and Tricare cost reports for the assigned Avera region.
  • Maintain oversight of the collection of the cost report information for the assigned locations and oversight of the governmental audits of all facilities.
  • Complete all requests for data and support documentation during the annual audit of financial statements for the 3rd party reserves for all Avera Health hospitals.
  • Responsible to monitor and interpret the state and federal regulatory publications and announcements, providing impact analysis for all Avera hospitals, clinics, nursing homes and other patient operating units.
  • Provide expertise, guidance, and advice to the rural network on reimbursement issues and cost report impacts as requested.
  • Assist as the financial liaison to stakeholders in all Avera regions regarding reimbursement matters / issues, general compliance, and charge master compliance relative to Medicare cost reporting.
  • Collaborate with Finance, Decision Support, and the Revenue Cycle by offering direction / guidance on reimbursement issues / concerns.

Essential Qualifications :

  • Bachelor's Accounting, Business, Finance or related field
  • 4-6 years experience in the healthcare environment with regulatory and cost reporting experience.
  • Preferred Education, License / Certification, or Work Experience :

  • Master's Accounting, Business, Finance or related field
  • Certified Public Accountant (CPA) - Board of Accountancy Upon Hire
  • Experience in all reimbursement settings such as, Prospective Payment Hospitals (PPS), Sole Community Hospitals (SCH), Critical Access Hospital (CAH), Rural Health Clinics (RHC), Skilled Nursing Facility (SNF).
  • Experience with IME, GME, Transplant, DSH, and Wage Index is a plus.
  • Expectations and Standards :

  • Commitment to the daily application of Avera's mission, vision, core values, and social principles to serve patients, their families, and our community.
  • Promote Avera's values of compassion, hospitality, and stewardship.
  • Uphold Avera's standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
  • Maintain confidentiality.
  • Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
  • Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.
  • Benefits You Need & Then Some :

  • PTO available day 1 for eligible hires.
  • Free health insurance options, for full-time single coverage on Avera High Deductible Health Plan
  • Up to 5% employer matching contribution for retirement
  • Career development guided by hands-on training and mentorship
  • Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

    serp_jobs.job_alerts.create_a_job

    Cost Manager • Sioux Falls, SD, US

    Job_description.internal_linking.related_jobs
    • serp_jobs.job_card.promoted
    Manager of Medicare Operations

    Manager of Medicare Operations

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Manager of Medicare Complaints Operations - Technical.Key Responsibilities Manage business operations and system initiatives to streamline complaint processes and maint...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Medicare Operations Manager

    Medicare Operations Manager

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Manager of Medicare Complaints Operations - Business Insight.Key Responsibilities Oversee support operations for the Medicare Complaints Department and manage the quali...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Mortgage Resolution Analyst

    Mortgage Resolution Analyst

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Mortgage Resolution Analyst III (Assumptions Focused Underwriter).Key Responsibilities Examine, evaluate, and pre-qualify loan assumption requests Review loss assumpti...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Revenue Cycle Specialist

    Revenue Cycle Specialist

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Revenue Cycle Specialist - Remote.Key Responsibilities Manage accounts receivable aging and analyze cash flow improvement opportunities Prepare escalation packages and...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Portfolio Reviewer

    Portfolio Reviewer

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Portfolio Reviewer.Key Responsibilities Overlay accounts to pre-defined trading models and execute trades based on product guidelines Analyze data for discrepancies be...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Manager of Resolution Strategy

    Manager of Resolution Strategy

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Manager, Resolution Strategy.Key Responsibilities Lead and develop a team of Senior Resolution Managers to ensure effective handling of complex complaints and escalatio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Reimbursement Case Manager

    Reimbursement Case Manager

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Reimbursement Case Manager.Key Responsibilities Provide inbound and outbound phone support as the primary contact for patients, caregivers, and providers Advocate for ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Pharmacy Revenue Cycle Analyst

    Pharmacy Revenue Cycle Analyst

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Claims Analyst - Pharmacy Revenue Cycle.Key Responsibilities Research and resolve rejected or underpaid pharmacy claims, ensuring accuracy in coding and billing Monito...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Senior Resolution Planning Associate

    Senior Resolution Planning Associate

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Sr Resolution Planning / Stress Testing Associate.Key Responsibilities Support the execution and maintenance of the institution's Resolution Plan in compliance with regul...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Wisconsin Licensed Reimbursement Auditor

    Wisconsin Licensed Reimbursement Auditor

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Reimbursement Auditing Specialist (Remote in Wisconsin).Key Responsibilities Assist in coding for various healthcare services including clinic, inpatient, and outpatien...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Remote Funding Manager

    Remote Funding Manager

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.filters.remote
    serp_jobs.job_card.full_time
    A company is looking for a Remote Mortgage Funding Manager to lead the development of their new funding department.Key Responsibilities Manage and execute loan funding across multiple states (wet...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Consulting Actuary - Medicare Risk Adjustment

    Consulting Actuary - Medicare Risk Adjustment

    Blue Cross and Blue Shield of North CarolinaSioux Falls, SD, United States
    serp_jobs.job_card.full_time
    As a Consulting Actuary at our healthcare organization, you will play a pivotal role in shaping the future of care delivery through data-driven insights and strategic actuarial expertise.You'll lea...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Subrogation Recovery Specialist

    Subrogation Recovery Specialist

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Subrogation Recovery Specialist.Key Responsibilities Manage and maintain various cases from creation to recovery with accurate documentation Prepare correspondence and...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Refund Specialist

    Refund Specialist

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Refund Specialist responsible for reviewing and resolving credit balances on patient accounts within the billing system. Key Responsibilities Audit encounters and accoun...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Collection Subrogation Specialist

    Collection Subrogation Specialist

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a UM Subrogation Specialist to manage collections and coordinate dispute resolutions.Key Responsibilities : Communicate with businesses to collect outstanding balances and...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Healthcare Collections Specialist

    Healthcare Collections Specialist

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Healthcare Customer Service Collections - Self-Pay.Key Responsibilities Handle inbound calls to arrange debt repayment based on patient financial situations Understand...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    RN Licensed Clinical Quality Manager

    RN Licensed Clinical Quality Manager

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Clinical Quality Manager for Population Health focused on the Medicare Shared Savings Program (MSSP). Key Responsibilities Leads system-wide population health projects a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Project Cost Manager

    Project Cost Manager

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director, Project Cost Management.Key Responsibilities Collaborate with stakeholders to establish and track project budgets and maintain cost control reports Prepare d...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    AR Specialist II

    AR Specialist II

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for an AR Specialist II, primarily remote.Key Responsibilities Contact insurance companies to secure outstanding payments and resolve complex claim rejections Monitor change...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Contract Review Specialist

    Contract Review Specialist

    VirtualVocationsSioux Falls, South Dakota, United States
    serp_jobs.job_card.full_time
    A company is looking for a Strategic Accounts Contract Review Specialist.Key Responsibilities : Review and manage all contract documents submitted for Strategic Accounts Secure and manage relatio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day