Sr. Reimbursement Consultant- Medicare/Medicaid
On-siteOrlando, Florida, United States
Job Summary
Prepare and submit accurate Medicare and CHAMPUS cost reports, amendments, and appeals while managing re-openings in accordance with federal regulations. Coordinate procurement of time studies, bed counts, and bad debt logs to support external reviews and optimize reimbursement for DSH, bad debts, and wage index reporting. Challenge adverse adjustments from government auditors, maintain enrollment records, and calculate third-party settlement balances for year-end audits. Identify process improvement opportunities, lead cross-functional teams, and disseminate regulatory changes to management to ensure compliance. Maintain updated knowledge of reimbursement laws and participate in project teams to conduct impact analyses and propose regulatory changes to CMS.
Required Qualifications
- 5 years of experience in preparing Medicare cost reports in a hospital system or consulting firm
- Experience in coordinating audits of Medicare cost reports
- Ability to use various reimbursement software and Microsoft Office applications
Desired Qualifications
- Bachelor's degree in Accounting, Finance or Business Administration
- CPA
- Database, HFS, SQL, Absolute, Lawson, and EPIC experience
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