Reimbursement Strategy Specialist

4 weeks ago

Taguig, Philippines Michael Page Full time

Be part of a growing shared services company in a non profit health care company Opportunity to gain pioneering experience in a hybrid work setup About Our Client Our client is a leading organization in the U.S. healthcare sector, recognized for its focus on innovation, high-quality patient care, and operational excellence. Its expanding global capability center in Taguig, Philippines offers a stable and mission-driven work environment, multinational collaboration, and strong prospects for long-term career advancement. Job Description Key Responsibilities of the Reimbursement Strategy Specialist: Prepare, review, and submit Medicare and Medicaid cost reports in compliance with regulatory standards. Analyze reimbursement trends, settlements, and projected rate impacts, including modeling payment changes. Provide guidance on regulatory reimbursement topics. Coordinate with CMS, MACs, and state agencies during audits, desk reviews, and appeals. Draft white papers, issue briefs, and executive summaries on reimbursement policy changes. Support financial planning by evaluating new service lines and providing reimbursement assumptions. Monitor CMS rulemaking, Medicaid programs, and healthcare payment regulations to identify risks and opportunities. Collaborate with Revenue Cycle, Managed Care, and Finance teams to align reimbursement strategies with organizational goals. The Successful Applicant Successful Candidate Profile - Reimbursement Strategy Specialist Holds a degree in Business, Health Administration, or a related field. Skilled in preparing and reviewing cost reports for Medicare and Medicaid. Knowledgeable in medical coding standards (ICD-9, CPT-4) and reimbursement methodologies. Proficient in Excel, financial modeling, and cost reporting software. Familiar with revenue cycle operations and Medicaid financing mechanisms. Able to communicate clearly, solve problems effectively, and work collaboratively. Maintains confidentiality and ensures accuracy in all documentation and reporting. What's on Offer Join a purpose-driven organization in the health and safety industry where your insights help shape financial strategy and improve operational outcomes. This role offers a hybrid work setup, a competitive compensation package, and the chance to contribute to high-impact initiatives. Located in BGC, you'll work alongside teams focused on regulatory compliance, financial planning, and strategic reimbursement. #J-18808-Ljbffr

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