Reimbursement Specialist

Responsibilities:

• 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

• 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

• 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

• 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

• 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