Corporate Senior Government Reimbursement Specialist

Prime Healthcare; Ontario (CA); On-site; USD 95,000 - 142,000; Full time

Job summary

Prime Healthcare, headquartered in Ontario, California, seeks a Corporate Senior Government Reimbursement Specialist. You will prepare complex government cost reports for a multi-hospital system and support audits across Medicare/Medicaid programs, ensuring accuracy and regulatory compliance.

The role requires extensive experience in hospital government reimbursement, familiarity with Besler EZWP/HFS/PS&R, and strong analytical and communication skills to coordinate with finance and operations

Qualifications

• Bachelor's degree in Accounting or Finance required.
• 15+ years in government reimbursement and cost reporting for multi-hospital systems.
• Experience preparing Medicare/Medicaid cost reports for multi-state hospital systems and supporting audits.
• Knowledge of Medicare rules on DSH, bad debts, charity, ESRD add-ons and related metrics.
• Experience with Besler EZWP, HFS, PS&R, 835 files, financial statements and patient data.

Responsibilities

• Prepare and support audits for government reimbursement reports.
• Understand how sections of cost reports connect and evaluate overall accuracy.

Skills

Analytical skills

Communication skills

Hospital GL

Patient accounting systems

Medicare/Medicaid knowledge

Education

Bachelor’s degree in Accounting or Finance

Tools

Besler EZWP

HFS

PS&R

835 files

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

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Responsibilities

Involved in preparation of various government reports and support their audits. The Corporate Senior Government Reimbursement Specialist is responsible for preparing and understanding the complexity of a cost report. The Corporate Senior Government Reimbursement Specialist fully understands how one section of the report is linked to another and be able to evaluate the accuracy of the entire report.

Qualifications

Required qualifications:

• Bachelor’s degree Accounting or Finance
• Minimum 15 years in Government reimbursement and cost report preparation experience in a multi-hospital system.
• Experience in preparing and completing entire Medicare and Medicaid cost reports for a multi-state hospital system and provide the support at audit
• Knowledge of Medicare rules on Medicare DSH, Medicare bad debts, charity and hospital bad debts for S-10, Interns and Residents FTE counts, ESRD Add-on, Nurse Allied Health Education, Rural Health Clinic, Sole Community Hospital, Critical Access Hospital and Low Volume Adjustment. Apply the knowledge when preparing the cost report and its subsequent audit.
• Experience working with Besler’s EZWP program, HFS, PS&R, 835 files, financial statement and patient account data.

Preferred qualifications:

• Strong analytical skills and resourceful
• Experience working with hospital GL and patient accounting systems (Lawson, EPIC, Meditech)
• Strong communication skills

Pay Transparency

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $94,848.00 to $142,272.00 on an annualized basis. The compensation estimate noted above is specific to California and has not been adjusted for any other geographic location. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf