Healthcare Reimbursement Manager (Remote)

Key Responsibilities

• Prepare and file Medicare and Medicaid cost reports in compliance with federal and state regulations.
• Manage third-party payer reimbursement processes, including commercial insurers, managed care organizations, and government payers.
• Identify and resolve underpayments, denials, and reimbursement discrepancies.
• Prepare monthly, quarterly, and annual reimbursement reports for leadership.
• Analyze cost report data to identify opportunities for revenue enhancement and cost containment.
• Ensure compliance with all applicable healthcare reimbursement regulations (CMS, state Medicaid, commercial payer requirements).
• Maintain thorough documentation to support cost report filings and audit defense.
• Partner with finance, operations, and clinical teams to align reimbursement strategies with organizational goals.

Requirements

• Previous experience in healthcare reimbursement, cost reporting, revenue cycle management, or relevant healthcare finance role is preferred.
• Experience preparing Medicare and Medicaid reports (using tools such as Medicare Cost Report e-Filing, ECAR, or similar).
• Deep understanding of third-party payer reimbursement methodologies (MS-DRG, APC, RBRVS, per diem, capitation, etc.).
• Familiarity with CMS regulations, state Medicaid requirements, and commercial payer policies.
• Proficiency in Microsoft Excel (pivot tables, formulas, data analysis). Experience with healthcare billing systems, EHR/EMR platforms, or revenue cycle management software is a plus.
• Strong quantitative and analytical skills with the ability to interpret complex reimbursement data.
• Excellent written and verbal communication skills with the ability to explain reimbursement concepts to non-financial stakeholders.
• Impeccable accuracy with the ability to spot discrepancies and ensure compliance.

Benefits

• Work from anywhere
• Competitive pay
• Flexible schedule
• Supportive and collaborative environment
• Opportunities for growth and advancement

Compensation