Reimbursement Specialist

UVA Health Charlottesville , VA 22901

Posted 7 months ago

This position is geared towards working with both Reimbursement and Managed Care Teams in order to have a deep understating of both areas. This person will have the flexibility and will maintain a fundamental knowledge of both commercial and governmental reimbursement methodologies.

To perform the functions of contractual allowances, reimbursement, cost reporting, revenue budgeting, and special projects. On the Managed Care side, assist with working in contract modeling, value-based contracts, reconciliation of patient accounting and assist in Medicaid and commercial contracting.

  • Determines transactions related to third-party reimbursement including contractual adjustments settlements receivable (payable) Medicare and Medicaid Cost Reports appeals amendments and re-openings.

  • Maintains competency in reimbursement by keeping knowledge of current developments at the State and Federal level and through continuing education.

  • Contract modeling, both commercial and governmental and loads and maintains APCs.

  • Performs or assists with profitability studies rate optimization and strategic pricing revenue volume and cost projections financial feasibility studies trend analysis and other decision support projects and reports.

  • Participates in design and planning of Hospital budget relating to rate setting and contractual adjustments.

  • Implements appropriate reporting mechanisms in conjunction with Director of Reimbursement and Managed Care Contracting Department.

  • Works with the Managed Care Team for commercial, Medicaid, and Medicare Advantage contracting. Also assists with value-based contracts.

  • Assists both Reimbursement and Managed Care Contracting with patient accounting and billing questions.

  • Works in conjunction with Patient Accounting staff to determine and resolve potential patient claim underpayments identified by Epic software.

  • Evaluates participating provider agreements and produces financial models for proposed agreements.

  • Meets all departmental specific competencies.

  • Adheres to medical center policies addressing infection control safety and personnel guidelines.

  • Demonstrates knowledge of and compliance with the hospital code of conduct and applicable corporate policies and procedures.

  • Maintains patient confidentiality and treats patients and their families with respect and dignity.

  • In addition to the above job responsibilities, other duties may be assigned.

  • Strong willingness to grow, continually challenge ideas and flexibility with new projects.

Position Compensation Range: $67,849.60 - $108,555.20 Annual

MINIMUM REQUIREMENTS

Education: Bachelor's Degree in Business Finance or related field is required.

Experience: 3 years' experience in Finance required.

Licensure: Certified Public Accountant Fellow HFMA (FHFMA) preferred. Experience utilizing Epic preferred.

PHYSICAL DEMANDS

Job requires sitting for prolonged periods. Proficient communicative, auditory and visual skills; Attention to detail and ability to write legibly.

The University of Virginia, including the UVA Health System and the University Physician's Group are fundamentally committed to the diversity of our faculty and staff. We believe diversity is excellence expressing itself through every person's perspectives and lived experiences. We are equal opportunity and affirmative action employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.


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Reimbursement Specialist

UVA Health