Senior Reimbursement Specialist
This position is responsible for the quarterly and annual OSHPD filings. It will also assist the Revenue Reimbursement Manager with the preparation of the annual Medicare cost report. It must maintain all Medicare Cost Report statistics (monthly and quarterly) in preparation for interim provision (support yearend financial audit) as well as annual filing.
The position will compile and track any payments and adjustments; assist analysis on charity care, denials, allowance for bad debt and any other analysis related to net patient revenue recognition. Through controlled documentation and standard analysis, this position partners with the Revenue Reimbursement Manager to drive integrity around our Medical Center revenue recognition
Policies & Procedures
This position will take a lead in documentation & process improvement of key revenue recognition processes. It will also be responsible for maintaining and updating all revenue related policies & procedures for City of Hope by working with the Revenue Reimbursement Manger, the Senior Revenue Accountant for Medical Foundation, and both internal stakeholders including Revenue Cycle and Finance leadership as well as external compliance government agencies.
Specific job responsibilities include:
- Responsible for the compilation of data and preparation of the quarterly and annual OSHPD Utilization Reports.
- Responsible for maintaining Medicare Cost Report statistics on a monthly and quarterly basis in order to support the interim and annual report filing process in accordance with Medicare/Medi-Cal laws, rules and regulations.
- Responsible for policies and procedures, both design and implementation, as they relate to compliance with laws, statutes and regulations dealing with reimbursement issues. Other accounting related policies and procedural development as necessary.
- Maintain and update policies and procedures associated with Medicare cost report and OSHPD report preparation. Ensure that these are updated and current with changes in reimbursement practices
- Assists in preparation of Medicare interim cost report and GME interim reports required for interim rate adjustment calculation.
- Assists in Medicare, Medi-Cal and OSHPD audits including coordination of audit requests and submission. Support the manager in preparation of audit documentation including responses to correspondences.
- Documentation and analysis of accounts to support Medicare/Medi-Cal cost reporting and OSHPD quarterly and annual reports which includes variance explanations for balance sheet and income statement accounts and maintenance of accounts and departmental crosswalk for Medicare, Medi-Cal and OSHPD reports.
- Support the manager in preparation of client schedules associated with year-end financial statement audit and ensure propriety of documentation submission including reconciliation of GL accounts prior to submission.
- Maintain and Reconcile Daily Payments and Adjustments which includes Allscripts review of missing patients to support the manager in month-end closing process. Information also to be used in analysis of charity care, denials, allowance for bad debt and other as needed analysis.
- Maintain, reconcile, documentation of Due to/From Third Party accounts and schedule for month-end closing.
- Preparation and submission of Medicare quarterly Credit Balance report.
- GME documentation and filing of IRIS GME report for Medicare cost report.
- Maintenance of Medi-Cal Remittance Advice to support Medicare, Medi-Cal, Bad Debts and Share of Costs audits which includes data collections such as TAR’s and EOB’s.
- Assist the manager in other functions such as submission of documentation to OIG and other regulatory reporting requirements.
- Assist with other year end related projects, including, but not limited to 990 tax return, AHA survey filings and data compilation and review as it relates to the reimbursement area.
- Interacts with all levels of management and personnel to provide useful information, guidance and integrity to the activities of the corporations
- Maintains professional growth and development. Keeps abreast of latest trends in the area of reimbursement and other compliance related assignments.
- Bachelor’s degree with Accounting/Finance emphasis
- 5+ years related Healthcare experience.
- CPA preferable
- Intermediate/advanced Excel skills (e.g. pivot tables & vlookups experience a plus)
- Demonstrated attention to detail and ability to multi-task to manage priorities
- Ability to work independently within tight deadlines
- Knowledge of Medicare and Medi-Cal rules, regulations and laws as it relates to completion of federal mandated cost reports.
About City of Hope
City of Hope, an innovative biomedical research, treatment and educational institution with over 4000 employees, is dedicated to the prevention and cure of cancer and other life-threatening diseases and guided by a compassionate, patient-centered philosophy.
Founded in 1913 and headquartered in Duarte, California, City of Hope is a remarkable non-profit institution, where compassion and advanced care go hand-in-hand with excellence in clinical and scientific research. City of Hope is a National Cancer Institute designated Comprehensive Cancer Center and a founding member of the National Comprehensive Cancer Network, an alliance of the nation’s 20 leading cancer centers that develops and institutes standards of care for cancer treatment.
City of Hope strongly supports and values the uniqueness of all individuals and promotes a work environment where diversity is embraced. City of Hope is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability.
Back to top