Reimbursement Specialist Jobs in Wisconsin

Major Responsibilities:

• Overseeing the completion of required monthly financial analyses for Enterprise Advocate Health service lines, including hospitals, medical groups, and continuing care.
• Assisting departmental leadership with Valuation Allowance accounts and supporting calculations with external financial auditors during year-end audits.
• Developing and forecasting Enterprise and Market net revenue budgets, ensuring accurate and timely budgeting for Gross and Net Patient Revenue.
• Partnering with Managed Health departmental leadership for the valuation of Medicare cost report reserves and monitoring reimbursement appeals and cost report settlements.
• Managing Medicaid supplemental payment accounting and ensuring reconciliation of balances with external financial auditors.
• Leading the explanation of budget to actual variances for Enterprise, Region, and Market contractual discounts.
• Overseeing the external financial statement audit process, including audit planning and preparation of audited financial statements.
• Acting as the finance representative for Epic and Net Revenue Projects, managing relationships with Revenue Cycle leadership.
• Ensuring ongoing compliance with Advocate Health’s internal control plan and directing the overall Accounting Operations internal controls.
• Directing departmental continuous process improvement and coordinating internal and external auditors’ requests and queries.

Licensure, Registration, and/or Certification Required:

• None

Education Required:

• Bachelor’s degree in accounting, or bachelor’s degree in finance or related field.

Experience Required:

• Typically requires 7 years of experience in health care reimbursement or public accounting with a concentration in hospital auditing that includes extensive auditing of the hospital net patient service revenue area, Medicare, Medicaid, or Blue Cross. Includes 3 years of management experience in managing staff and budgets.

Knowledge, Skills & Abilities Required:

Physical Requirements and Working Conditions:

• This position requires travel, therefore, will be exposed to weather and road conditions.
• Operates all equipment necessary to perform the job.
• Exposed to a normal office environment.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.