Manager Reimbursement

Job description

Overview The Reimbursement Manager ensures compliance with regulations related to governmental and commercial reimbursement programs and works to mitigate the risk of loss of income and seize opportunities to provide value throughout the reimbursement process. This includes completion of governmental cost reporting, payor audits and providing interim reimbursement estimates. Responsibilities: Key Responsibilities / Essential Functions: - Serves as primary resource for the DCH Health Care Authority to monitor and interpret Federal and State reimbursement regulations. Develops strategies to ensure proper reimbursement. Maintains proficiency in the use of the Federal Register and a thorough knowledge of Medicare, Medicaid, Tricare (Champus) and Blue Cross-reimbursement principles and regulations. - Directs and assists with accurately preparing, completing, and reviewing any regulatory reports required by third-party and governmental agencies regarding Authority reimbursement. - Serves as the primary liaison with external auditors and government agencies. - Reviews and ensures proper third-party reimbursement. - Monitors federal and state legislative changes for upcoming changes associ...