Medicare/Medicaid Reimbursement Lead — Remote

Lehigh Valley Health Network, Inc.; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

Lehigh Valley Health Network, Inc. seeks an experienced professional to interpret Medicare and Medicaid payment regulations and lead cost reporting activities for the organization.

The role focuses on ensuring accurate cost reports, optimizing reimbursement across all programs, and providing expert guidance on compliance and opportunities for improvement. Strong independent work and collaborative skills are essential in a remote setup.

Qualifications

• Bachelor’s Degree.
• 5 years interpreting Medicare and Medicaid payment regulation and completing Medicare and Medicaid cost reports.
• 5 years recording revenue and determining cost settlement receivables/payables for Medicare and Medicaid payments.
• Ability to work independently.

Responsibilities

• Calculates the financial impacts of purchasing, readmissions, hospital acquired infections, and accountable care arrangements.
• Develops strategies and processes to ensure compliance with Medicare/Medicaid regulations.
• Develops processes to complete cost reports and ensure reimbursement for all programs and services.
• Provides expert guidance on Medicare and Medicaid reimbursement and payment regulations.
• Identifies opportunities to maximize reimbursement for all hospital programs and services.
• Supports participation in cost report appeals and related group appeals.
• Evaluates firms for cost report appeals and selects appropriate consultants.
• Supports revenue budgeting related to cost report-driven reimbursements.
• Reviews third-party settlements monthly and aligns with close schedules.

Skills

Medicare/Medicaid regulation

Cost reporting experience

Independent work

Education

Bachelor's Degree

Job description

Lehigh Valley Health Network, Inc. seeks an experienced professional to interpret Medicare and Medicaid payment regulations and lead cost reporting activities for the organization.

The role focuses on ensuring accurate cost reports, optimizing reimbursement across all programs, and providing expert guidance on compliance and opportunities for improvement. Strong independent work and collaborative skills are essential in a remote setup.