Job Details
Description
* Position is eligible for Remote / Work from Home opportunity *
Department: NPA
Telecommuting Eligible: Yes
Job Grade: N13
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 accounting 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.
An employee in this position may be required to possess a “Federal Identification Card” (Federal ID) as a condition of employment. Federal ID’s may include one of the following: Personal Identity Verification (PIV) card, Personal Identity Verification-Interoperable (PIV-I) card, a Local-Based Physical Access Card issued by CMS, or a Local-Based Physical Access Card issued by another Federal agency and approved by CMS. Obtaining a Federal ID and continued eligibility for this position may require the successful completion of a Federal Background Investigation performed by the Federal Government and a residency requirement that you have lived in the United States at least three out of the last five years. Failure to obtain a Federal ID may result in the removal from the position or termination of employment.
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 - $26.16
Other Compensation: Self-Managed PTO (if applicable), Incentive Plan
Lifestyle Benefit: $50/month
This job will be closed 01/02/2025 at 8:00AM CST. No further applications will be considered.
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)
