Clinical Reimbursement Specialist

Erickson Living
Catonsville, MD
Sep 15, 2017
Sep 18, 2017
Accountant, IT
Full Time
Erickson Living is hiring a Clinical Reimbursement Specialist to support our 18 Continuing Care Retirement communities. This position will provide education, training, Medicare/Medicaid regulatory updates, analysis of trends related to reimbursement and general oversight of clinical documentation that impacts Medicare and Medicaid reimbursement in Continuing Care, Home Health and Hospice Services throughout our communities. ESSENTIAL DUTIES AND RESPONSIBILITIES: include the following. Other duties may be assigned. * Develop, implement and evaluate reimbursement priorities for health services in conjunction with other corporate partners (Finance, Health Operations, and Ancillary Services). * Monitor Medicare and Medicaid reimbursable services to assure proper utilization of services to ensure appropriate reimbursement. * Monitor and conduct audits of Medicare services and work with the business lines to create and implement action plans to improve outcomes and reimbursement rates. * Monitor key reimbursement metrics in each health care business line to identify trends. Work with the communities that require assistance to accurately capture resources related to Medicare Reimbursement. * Maintain current knowledge of changing regulations related to Medicare and Medicaid reimbursement. Keep Corporate partners, Health Services, Communities and all required parties updated on any new regulations impacting reimbursement of our business lines. * Provide education and training materials on new processes, regulations or systems related to Clinical Reimbursement of Medicare or Medicaid services. * Participate in the budget process to ensure that Medicare and Medicaid rates are budgeted accurately as possible. * Work with Corporate Compliance to enhance auditing processes related to Medicare and Medicaid reimbursement and documentation. * Co-lead preparations and calls for routine "triple check" process, to help assure claims accuracy and facilitate prompt reimbursement * Current and maintained AANAC Certification is required within the first 6 months of employment * Proficient experience in Medicare Reimbursable services in any or all of the following: SNF, Certified Home Health, Out Patient Rehabilitation, Inpatient Rehab services or Hospice. * Proficient in Medicare and Medicaid regulations

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