**Primary City/State:**

Phoenix, Arizona

**Department Name:**

Reimbursement Services-Corp

**Work Shift:**

Day

**Job Category:**

Finance

Great careers are built at Banner Health. We understand that talented professionals appreciate having options. We are proud to offer our team members many career and lifestyle choices including remote work options. Apply today, this could be the perfect opportunity for you.

This position is responsible for maximizing the Medicare/Medicaid/Champus reimbursement for all entities with multiple reimbursement variations and/or specialty areas and _requires_ Medicaid/Champus reimbursement

Excel, MS4, EZ Workpapers, HFS, PowerBI, Lawson

Scheduled: Monday - Friday 8 - 5 AZ Time

This can be a remote position if you live in the following states only:

**AK, AZ, AR, CA, CO, GA, FL, IA, ID, IN, KS, KY, LA, MD, MI, MO, MN, MS, NH, NM, NY, NC, ND, NE, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WI,**

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

POSITION SUMMARY

This position is responsible for maximizing the Medicare/Medicaid/Champus reimbursement for all entities with multiple reimbursement variations and/or specialty areas (ex. Medical Education, Transplant Program, Bond Interest Reporting, etc.) reported through the annual cost reports and the Part B Carrier billing for professional fees. Serves as a resource for personnel for all Medicare/Medicaid/Champus reimbursement issues.

CORE FUNCTIONS

1. Calculates, reviews, and analyzes the monthly contractual allowance for Medicare, Medicaid , and/or Champus. Prepares a quarterly analysis of the accounts receivable reserve to ensure the provisions are adequate. Prepares the Medicare/Medicaid/Champus cost reports using data from multiple sources. Ensures the maximum third-party reimbursement is reported through the cost reports and to the Carrier for professional fees.

2. Provides information to the third-party auditors to support the data reported and ensures maximum reimbursement. Reviews proposed audit adjustments to ensure accuracy. Coordinates appeals and exception requests. Provides information to the financial auditors for reimbursement related accounts including current year and prior year reserves.

3. Calculates the reimbursement impacts for the organizational changes, regulatory changes in reimbursement, and/or payment changes by the intermediaries and carriers.

4. Acts as a resource for management, facility controllers, department directors, committees, teams, etc. related to all Medicare/Medicaid/Champus reimbursement issues. Maximizes reimbursement by working with various personnel. Provides Medicare/Medicaid/Champus reimbursement education/training to the Reimbursement Services staff and other financial/facility staff.

5. Obtains knowledge of source documents (General Ledger, Income and Expense Summary, Stat and Revenue Report, Patient Account System, Cost Accounting System, Accounts Payable System, etc.) to determine the most accurate information to be reported.

6. Requires the ability to work with a variety of personnel including system personnel, Internal and external auditors as appropriate, and external customers as appropriate.

MINIMUM QUALIFICATIONS

Requires a Bachelor degree in business, accounting or related field or equivalent experience.

Requires advanced knowledge of Medicaid/Champus reimbursement. Knowledge of Medicare reimbursement regulations to include different inpatient reimbursement methods, and specialty areas and maintain highly confidential data. Must be able to work with minimal supervision and prioritize multiple projects. Requires excellent human relations skills and the ability to effectively interact and communicate both verbally and in writing with all levels staff and outside professionals.

Proven advanced, analytical, and modeling skills are necessary. Must be proficient in the use of sophisticated software programs.

PREFERRED QUALIFICATIONS

Additional related education and/or experience preferred.

**EEO Statement:**

EEO/Female/Minority/Disability/Veterans (https://www.bannerhealth.com/careers/eeo)

Our organization supports a drug-free work environment.

**Privacy Policy:**

Privacy Policy (https://www.bannerhealth.com/about/legal-notices/privacy)

EOE/Female/Minority/Disability/Veterans

Banner Health supports a drug-free work environment.

Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability