Must possess knowledge and understanding of the Medicare Cost Report, NJ Acute Care Reporting and other regulatory requirements.
Schedule:
Hybrid - three days onsite, two days remote.
Job Summary:
The Manager of Reimbursement serves as the health system's primary subject matter expert for Medicare reimbursement, governmental regulations, and complex reimbursement methodologies. This role maintains full ownership for the preparation, review, and submission of the annual Medicare and NJ State cost reports, as well as oversight of related reimbursement and audit activities.
The position requires advanced knowledge of acute care hospital reimbursement, New Jersey reimbursement methodologies, and evolving federal and state regulatory requirements. Working closely with Corporate Finance leadership and external regulatory agencies, the Manager of Reimbursement identifies opportunities to optimize reimbursement outcomes, interprets regulatory changes, and provides strategic guidance that supports the organization's financial performance and long-term reimbursement strategy.
This is a highly specialized reimbursement leadership role. The ideal candidate will possess demonstrated end-to-end ownership of Medicare cost reporting and extensive experience in hospital reimbursement within a complex acute care health system environment, i.e.; Chapter 160 cost reports, Wage Index submissions, NJ DSH, Occupational Mix surveys, PPS calculations, IME/GME appeals, and regulatory analysis.
Position Responsibilities:
Responsible for coordination and completion of the data for the Medicare/Medicaid Cost Reports and all reimbursement surveys and empowers the staff to make recommendations for improvements.
Coordinates all 3rd party audits with government intermediaries. Lead contact person with scheduling audit, gathering all requested information, fielding questions, and analyzing impact of audit adjustments.
Monitors and trends the impact of Medicare and Medicaid regulations. Reviews and analyzes relevant information related to Medicare regulatory compliance issues.
Provides monthly, quarterly, and special request reports related to patient detailed data for Operational Management through data reporting.
Implements new systems related to financial controls and assists in matters as they relate to reimbursement operations. Serves as System Administrator in various reimbursement systems for IE: Cost report system and other CMS systems.
Position Qualifications Required:
Required Experience:
Five to seven years of Reimbursement experience required with one to three years supervisory experience preferred. Must possess knowledge and understanding of the Medicare Cost Report, NJ Acute Care Reporting and other regulatory requirements. Ability to work independently to achieve goals and prioritize work assignments. Excellent organizational, analytical, problem-solving, and communication skills. Must have a working knowledge of Windows, Word, and Excel. Thorough knowledge of general ledger software packages. Oracle and/or EPIC experience a plus.
Required Education:
Bachelor's of Business Administration in Accounting or Finance required. Certification as public or managerial accountant or Master's Degree in Business Administration in related field is preferred. "
