Reimbursement Specialist

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The Reimbursement Specialist is responsible for assisting with the annual generation of the Cost Report. This role operates under the guidance of the Reimbursement Manager and utilizes organizational and communication skills to manage data collection and entry, maintain logs and records, analyze reimbursement data and trends, perform clerical duties, and collaborate with internal and external stakeholders to ensure accurate data availability and Cost Report creation.

• Work with the Business Office and IT to gather information needed to submit supplementary information with Medicare cost reports and Medicaid DSH surveys.
• Assist with collecting information for yearly Cost Reports and input on various work papers.
• Maintain and send out all cost report requests and follow up on missing data for internal and external sources.
• Maintain Medicaid eligibility logs for cost reports, including maintaining access to Medicaid Eligibility sources.
• Research and log DSH Audit details.
• Research and log DSH survey data for MS Medicaid, Medicaid Out of State, and Uninsured accounts.
• Collaborate with the manager and internal/external auditors to support S-10 and other audit processes by gathering, verifying, and submitting required data, including sample data, invoices, claims, EOBs, eligibility verification, and patient day information.
• Support the year-end cost report process by coordinating and validating data submissions for bad debt logs with third-party vendors, reconciling nursing home day counts, and maintaining accurate records for final audited cost reports and reimbursement documentation.
• Gather and maintain access to PS&R data for various projects.
• Monitor and track pass-thru payments, Managed Care MHAP payments, DOM UPL payments, and DOM DSH payments.
• Perform clerical duties such as ordering supplies and handling mail and packages.

• High School Diploma or GED - Required
• Associate's Degree - Preferred

• 1-3 years. Minimum of 2 years  reimbursement or healthcare billing experience - Preferred

• Extensive knowledge of NMMC AR system
• Working knowledge of 3rd party insurance agreements and payment methodologies
• Good organizational and written and verbal communication skills
• Excellent data-entry skills
• Excellent interpersonal skills
• Extensive knowledge of Microsoft Excel and other Microsoft Office software, One Drive, Adobe Pro, and various websites
• Ability to work independently with initiative and good judgment
• Detail-oriented, self-motivated, and results-driven
• Professional level of expertise and confidentiality

• Continuing Education
• 403B Retirement Plan with Employer Match Contributions
• Pet, Identity Theft and Legal Services Insurance
• Wellness Programs and Incentives
• Referral Bonuses
• Employee Assistance Program
• Medical Benefits
• Dental Benefits
• Vision Benefits
• License and Certification Reimbursement
• Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance
• Employee Discount Program
• Early Access to Earned Wages
• Tuition Assistance
• Relocation Assistance
• Paid Time Away
• Special Employee Rates at NMMC Wellness Centers

• Entry level

• Full-time

• Finance and Sales

• Hospitals and Health Care