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Reimbursement Specialist

Job ID: 137553
Accounting/Finance
FT
Philadelphia, PA, United States
Jun 2, 2022

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Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary:

  • The NJ Reimbursement Specialist will provide reimbursement and financial support to both corporate and hospital leadership in an efficient and customer-focused manner. The specialist will report to the Reimbursement Manager. The major focus of this position will be on New Jersey specific reimbursement filings and regulatory issues.

Responsibilities:

Patient/Customer:
  • Provide technical and consultative support for entities and Corporate Services in all applicable facets of Reimbursement and Financial Planning in a professional manner
  • Develop and maintain a customer service driven work environment within all areas of responsibility
  • Maintain Project Logs for all assigned projects
  • Perform special projects, as assigned
Operations:
  • Ad Hoc Analyses and Information
  • Review request and collect data from appropriate sources
  • Review data received and forward to requesting party
  • Medicare, Medicaid, Champus, CRC, Regulatory Compliance, Required Cost Report and PIP Filings:
  • Assist in the analysis of the impact of new State regulations on New Jersey Hospitals
  • Assist with all aspects of the cost report related activities, including PIP filings, Wage Index submission and regulation interpretation
  • Request, analyze and summarize data for input from entity Finance personnel and departments
  • Prepare cost reports in accordance with third-party rules and regulations for entity review and approval
  • Assist in the proper and timely filing of cost reports and other New Jersey state regulatory submissions
Graduate Medical Education Finance:
  • Assist Graduate Medical Education Department in the development of resident FTE budgets
  • Assist department leadership and GME office with Resident billing analysis
  • Assist residency coordinator with resident financial issues when needed
New Jersey Regulatory:
  • Work with team liaison to Penn Medicine Princeton Health on cost report and reimbursement issues
  • Develop a strong knowledge on New Jersey Medical Assistance and Uncompensated Care Regulatory requirements
  • Assist in the completion of all necessary interim and final submissions relative to Princeton Cost Reports
  • As needed, work with Reimbursement Manager and external consultant performing work related to Princeton and/or New Jersey requirements; assist Reimbursement Manager with completing submissions with minimal use of external consultants
  • Assist with audit requests and the preparation of re-openings, as necessary
Staff Development:
  • Mutually develop and implement learning and development plans for teaching New Jersey regulations to the analysts and others in the department
  • Performs duties in accordance with Penn Medicine and entity values, policies and procedures.
  • other duties as assigned to support the unit, department, entity, and health system organization. 

Credentials:

  • HFMA Certified Healthcare Finance Professional (CHFP) - Preferred

    Education or Equivalent Experience:

    • Bachelor’s Degree required; preferably in Accounting, Finance, or Business Administration.
    • 3+ years of third-party governmental reimbursement experience is required (including compliance analysis, revenue budgeting, and cost reporting activities from PIP establishment to final settlement)
    • 3+ years New Jersey Regulatory filings is preferred

    Skills & Abilities:

    • Strong quantitative and analytical abilities
    • Ability to communicate with internal and external constituents
    • Able to translate complex information into simple explanations
    • Ability to manage concurrent projects while meeting project deadlines
    • Familiarity with Graduate Medical Education training programs
    • Clear and demonstrated understanding of health care financing
    • Understanding of Federal Regulatory process impacting Medicare Reimbursements
    • Understanding the New Jersey regulatory process impacting Medicaid Reimbursements
    • Knowledge of Hospital Medicare and Medicaid Reimbursement

    We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

    Live Your Life's Work

    We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

       Current UPHS employees must apply HERE
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