Reimbursement Manager

Lehigh Valley Health Network

Manager overseeing Medicare and Medicaid cost reports to ensure compliance and appropriate reimbursement. Collaborating with hospital teams, managing appeals, and leading training efforts for reimbursement policies.

Posted 7/30/2026full-timeRemote • Pennsylvania • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Medicare and Medicaid reimbursement regulations, ensuring compliance and accuracy in cost report submissions. Capable of developing processes and strategies to optimize reimbursement and train staff on hospital reimbursement issues.

Highest-signal resume keywords

Medicare And Medicaid Cost ReportingRegulatory ComplianceRevenue Budget Process SupportData AnalysisStaff Training

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Cost Report PreparationFinancial AnalysisRevenue RecordingCost Settlement ManagementRegulation InterpretationProcess DevelopmentData ReviewCompliance MonitoringAppeals ParticipationHospital Reimbursement Expertise

Soft Skills

Independent WorkFast-Paced Environment AdaptabilityProblem-Solving

Tools & Technologies

MS Office

Industry Keywords

Medicare RegulationsMedicaid RegulationsAcute Care EnvironmentCost Reporting ComplianceThird Party Settlements

About the role

Key responsibilities & impact

Oversees Medicare and Medicaid cost reports submitted system wide to obtain appropriate reimbursement from these programs and monitor hospitals' compliance with internal reimbursement policies and procedures
Interprets Medicare and Medicaid regulations and directs hospital activities to comply with government payment regulations
Critically reviews proposed adjustments to cost reports and assists the Director and Vice President decide which adjustments should be appealed
Develops processes needed to complete cost reports and ensure payments for all programs and services
Develops strategies and implement processes to ensure the hospitals are in compliance with Medicare and Medicaid regulation
Responsible for the accuracy of system wide Medicare and Medicaid cost report submissions
Provides expert guidance on complying with Medicare and Medicaid reimbursement and payment regulation
Identifies opportunities to achieve reimbursement for all programs and services provided
Participates in cost report appeals and cost report group appeals
Supports the revenue budget process for items where reimbursement is calculated on the cost report
Reviews third party settlements monthly and updates in accordance with the monthly and fiscal year closing schedules
Oversees hiring, training and colleague performance
Periodically visit hospitals to assure compliance with cost reporting data collection requirements and address questions or operational challenges

Requirements

What you’ll need

Bachelor’s Degree in Accounting, Finance, or related field
5 years experience interpreting Medicare and Medicaid payment regulation and completing Medicare and Medicaid cost reports
5 years experience recording revenue and determining cost settlement receivables/payables for Medicare and Medicaid payments
3 years in a hospital/acute care environment
High-level of MS Office skills needed
Able to train staff in technology and hospital reimbursement issues
Ability to work in a fast paced environment
Able to review large amount of data
Ability to work independently

Benefits

Comp & perks

Health insurance
401(k) matching
Flexible working hours
Paid time off
Professional development opportunities