Senior Reimbursement Specialist

Location:Lee Health -2776 Cleveland AveFort Myers FL 33901

Department: Financial Svs

Work Type: Full Time

Shift: Shift 1/8:00:00 AM to 4:30:00 PM

Minimum to Midpoint Pay Rate:$40.36 - $52.47 / hour

The Senior Reimbursement Specialist is responsible for government payer reimbursement, including Medicare and Medicaid, and maintaining monthly Net Revenue and Net AR. This role ensures compliance with government regulations, prepares Medicare Cost Reports, manages Florida Medicaid payment systems, and stays updated on regulatory changes. Communication of the government regulations, including changes and complex reimbursement activity to Leadership is a necessary part of the duties.

• Prepare and analyze Medicare/Medicaid cost reports, settlements, and audits.
• Full understanding of DSH, PPS/OPPS, S-10 and Wage Index calculations and impact on Reimbursement.
• Maintain Net AR contractual reserve accounts using Kodiak Revenue Cycle Analytics.
• Analyze GME & IME data, including costs, resident FTEs, caps, and reimbursements.
• Ensure accurate reporting of resident rotations using IRIS and GME data systems.
• Coordinate all State Medicaid Special Payment Programs reporting.
• Support financial reporting, month-end revenue valuations, and cost variance analysis.
• Conduct regulatory impact analysis and present findings to leadership.
• Assist with IRS 990 data collection and Schedule H-Community Benefit reporting.
• Serve as a key contact for reimbursement-related inquiries and external audits.

This role is critical to financial performance and is highly visible to senior leadership. The Senior Reimbursement Specialist operates independently and contributes significantly to the reimbursement and financial analysis functions within the organization.

Education: Bachelors degree in accounting, finance, or healthcare administration required. Masters preferred.

Experience: Minimum of 5 years experience in healthcare finance/reimbursement with a minimum of 3 years' experience in Medicare Cost Report filings. Considerable expertise in reimbursement principles and revenue cycle processes.

Certification: N/A

License: N/A

Other:Advanced proficiency in Microsoft Excel; experience with Syntellis Axiom and Strata Cost Accounting, HFS Cost Reporting, INFOR FSM, EPIC a plus. Strong analytical, organizational, and communication skills.

US:FL:Fort Myers