Benefits:

15% Night differential
20 Paid Time Off (PTO) per year
Annual Appraisal
Annual Incentive
Hybrid Work Arrangement
Weekends off
HMO plus free dependents
Group life insurance

Job Description:

Responsible for the accurate completion, review, and on time filing of all Medicare and Medicaid cost reports to obtain appropriate reimbursement from these programs and monitor our hospitals compliance with the company’s reimbursement policies and procedures.
Prepare all required Medicaid supplemental reports and Tricare Capital/DME Reimbursement reports to procure all amounts due from these government programs as applicable for our hospitals.
Individual must be capable of handling multiple projects and accustomed to working with hard set deadlines.
Be familiar with CMS regulations surrounding the rules and instructions for reimbursement through a Medicare cost report (PRM 15-1 and 15-2 and CFR Part 412) and stay abreast of changes and updates to these rules and regulations throughout the year as they are released. Have knowledge of the consequences to Tenet and/or the hospitals for fraudulent data reported through the cost report.
Compose audit workpapers and gather backing documents necessary so that audit staff are prepared for all CMS Medicare and Medicaid audits and cost report amounts reported are thoroughly supported. Explain any material variances in costs, charges, or manners of reporting as they arise.
Promptly communicate reimbursement and compliance issues to management once they are identified so they can be addressed and resolved in a timely manner.
Review prior year audit findings and adjustment reports and incorporate any changes necessary into the preparation of the current year report.
Understand the cost reimbursement of Intern and Resident programs and the rules and regulations that surround the proper reporting of these programs in the Medicare cost report.

Qualifications:

Bachelor’s Degree in accounting/business with minimum 2-3 years’ experience in Medicare and/or Medicaid reimbursement. Prefer at least some cost report preparation experience.

Working Conditions:

Hybrid (BGC, Taguig)
Night Shift work schedule

Reimbursement Specialist

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