Reimbursement Specialist I - REMOTE

* Position is eligible for Remote / Work from Home opportunity * Department: Provider Audit- Reimbursement Telecommuting Eligible: Yes Job Grade: N12 Notice of Collection & Privacy Policy for Applicants Residing in California: California Applicant Privacy Policy | Noridian (noridiansolutions.
com) Job Title Reimbursement Specialist Job Summary The Reimbursement Specialist is responsible for the management, analysis, accuracy, and timeliness of Medicare cost report acceptance, tentative and straight to final settlements, Medicare interim rates and applicable limits for all providers in the Fiscal Intermediary Shared Systems (FISS).
This position ensures the proper reimbursement for Medicare health care providers.
Essential Functions Key Duties/Responsibilities/Accountabilities Processes cost report correspondence which may include mail correspondence, cost report processing, tentative and final settlements.
Performs analysis of cost report documentation to determine acceptability criteria is met to accept cost report.
Updates systems (FISS, STAR) with applications processed by Provider Enrollment.
Updates systems to reflect rate changes derived from payment rate reviews, provider reviews, and CMS-mandated changes.
Builds constructive working relationships with clients/customers, other work units, and other individuals to meet mutual goals and objectives.
Collaborates with Recoupment, Systems Support, Provider Call Center, Provider Audit, Provider Enrollment, PreProcess, and Provider Education to support providers on various payment and systems issues.
Answers provider questions on payments, cost reports, and other reimbursement issues.
Mentors new and existing staff.
Actively collaborates with members of the team to ensure department goals and timeliness are met.
Contributes positively to a team-based work environment by actively seeking and providing feedback, participating in team and divisional goals, and streamlining and improving processes.
Non-Essential Duties and Functions Other duties as assigned Attends training courses/workshops Minimum Qualifications High school diploma or GED.
1 year of work experience in customer service, general office, accounting or healthcare.
Accurate data entry.
Demonstrated problem solving skills.
Preferred Qualifications Above requirements and the following: 2 years' experience in accccounting or healthcare.
Effective oral and written communication skills.
Excellent attention to detail and high level of accuracy.
Excellent time management and customer service skills.
Critical thinking and analysis skills.
Environment and Cognitive/Physical Demands Office Environment Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve Requires prolonged sitting and telephone use Requires the use of office equipment such as computer terminals, telephones, copiers and printers Infrequent lifting to 15 pounds Infrequent stooping Segregation of Duties Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.
Statement of Other Duties This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions.
Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.
Total Rewards Package: Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Severance Package, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.
CMS Access Compliance and Regulation Contingency Statement Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.
Equal Employment Opportunity Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.
Below is the salary range for potential new hires.
Salary Range: $17.
20 – $23.
69 Other Compensation: Incentive Plan Lifestyle Benefit: $50/month This job will be closed 02/09/2024 at 8:00AM CST.
No further applications will be considered.
Education Required General Ed Diploma or better in Business Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
41 CFR 60-1.
35(c)