Reimbursement Specialist

• 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.

• 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. 

• Ensures reimbursement optimal rates and codes are implemented and communicated to the departments and helps the charge master analysts in the establishment of all hospital services rates.  

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

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 Siemen's preferred.                      

PHYSICAL DEMANDS

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

Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance

• Paid Time Off, Long-term and Short-term Disability, Retirement Savings

• Health Saving Plans, and Flexible Spending Accounts

• Certification and education support

• Generous Paid Time Off

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report “Best Hospitals” guide rates UVA Health University Medical Center as “High Performing” in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children’s is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA’s commitment to non-discrimination and equal opportunity employment.