Reimbursement Specialist

The Reimbursement Specialist is responsible for managing and ensuring the accuracy and timeliness of Medicare cost report acceptance, tentative and straight-to-final settlements, interim rates, and applicable limits for all providers in the Fiscal Intermediary Shared Systems (FISS). This position plays a vital role in securing proper reimbursement for Medicare healthcare providers.

• →Process cost report correspondence, including mail, cost report submissions, and settlement documentation (tentative and final)
• →Analyze cost report documentation to determine whether acceptability criteria are met for submission
• →Update systems such as FISS and STAR with application data from Provider Enrollment
• →Maintain system accuracy by updating rate changes based on payment rate reviews, provider reviews, and CMS-mandated changes
• →Build constructive working relationships with internal teams, clients, and customers to meet shared goals
• →Collaborate with departments such as Recoupment, Systems Support, Provider Call Center, Provider Audit, Provider Enrollment, PreProcess, and Provider Education to resolve provider issues
• →Respond to provider inquiries regarding payments, cost reports, and reimbursement-related topics
• →Mentor and support onboarding and development of new and existing staff
• →Collaborate with team members to achieve departmental goals and ensure timely task completion
• →Contribute to a positive team environment through feedback, process improvement, and participation in team goals

• High school diploma
• At least 1 year of experience accounting, or healthcare
• Strong data entry accuracy
• Demonstrated problem-solving skills

• 2 years of experience in accounting or healthcare
• Effective oral and written communication skills
• Strong time management and customer service orientation
• High attention to detail and accuracy
• Strong critical thinking and analytical abilities

After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting.

Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law.

Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).