Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

The Senior Reimbursement Specialist will facilitate the timely and accurate submission of various critical Third-Party reimbursement requirements on behalf of the Hospital. Additionally, the Specialist will perform the analysis and posting of the Hospital's contractual and allowances monthly, which annually exceeds $1.0 billion. Furthermore, the Specialist will ensure that all third-party cost reporting and other government application requirements which are required by federal, state, and private insurance agencies have been properly met and filed on a timely basis.

Job Duties:

• Responsible for monitoring the daily revenue postings from Epic to Workday ensuring timely revenue recognition and prompt resolution to any interface errors.
• Review's the classification, computation, and processing accuracy of third-party billings and reimbursement. Communicates with Patient Financial Services and Director of Third-Party Reimbursement regarding problems/opportunities.
• Assists in the preparation of the monthly contractual analysis for the various payors utilizing the Crowe RCA tool, including the daily reconciliation of the accounts receivable uploads and mapping tables to Epic.
• Assists with cost report preparation at fiscal year-end close by preparing work papers, compiling information, preparing spreadsheets for analysis, and entering data into the cost report software.
• Data collector of critical data elements required to complete the initial and final Health Resources and Services Administration ("HRSA") applications for the Graduate Medical Education funding.
• Oversee the compilation, accuracy and timely filing of the Intern and Resident Information System ("IRIS") reporting to Centers for Medicare and Medicaid Services ("CMS") as part of the cost reports.
• Preparer of key schedules for the annual financial audit, 990 tax returns (i.e., Schedule H), surveys, and several State reporting requirements.
• Acts as liaison between Third Party Reimbursement and those areas that supply information for cost reporting purposes such as Facilities Management, Budget Analytics, Medical Staff Office, and Administrative Services to ensure that information is maintained on a current basis.
• Assists with various third-party special projects, including but not limited to estimating contractual during the annual budgeting cycle and developing payor mix scenarios to assist Senior Management in decision making.
• Acts as liaison and preparer of assigned audit requests between Director and third-party intermediaries during various field audits, included but not limited to governmental and external financial audits.
• Monitors current developments in healthcare and third-party reimbursement and uses this knowledge to improve job functions as appropriate.
• Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers, and others.

Knowledge, skills and abilities:

• Bachelor's degree in accounting required. CPA or MBA designation strongly desired. HFMA certification strongly desired.
• Minimum of seven years of relevant experience to include at least three years healthcare reimbursement experience required.
• Demonstrated basic knowledge of third-party payment principles and regulations, thorough understanding of third-party cost reporting forms and requirements.
• Prior experience with General Ledger, Billing/Accounts Receivable, or Healthcare reimbursement preferred.
• Proficiency with enterprise-wide financial systems, such as Workday as well as advanced knowledge of Excel. Crowe RCA knowledge preferred.
• Strong organization skills. Ability to demonstrate a strong commitment to customer relationships by taking ownership of issues and ensuring effective outcomes.
• Time management skills are required to manage multiple, concurrent tasks, meet deadlines, and maintain confidentiality.
• Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change. Ability to interpret and apply complex policies and procedures, develop innovative approaches, and adapt to changes in policies and technologies.
• Excellent interpersonal and written communication skills, analytical skills, ability to meet deadlines, and to manage projects across programs. Demonstrated ability to proactively solve problems.

Education

Benefit Statement

For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:

Medical, dental and vision insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO), Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match

Various voluntary benefits:

• Supplemental Life, AD&D and Disability

• Critical Illness, Accident and Hospital Indemnity coverage

• Tuition assistance

• Student loan servicing and support

• Adoption benefits

• Backup Childcare and Eldercare

• Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members

• Discount on services at Lurie Children's facilities

• Discount purchasing program

There's a Place for You with Us

At Lurie Children's we embrace and celebrate diversity and equity in a serious way. We are committed to building a team with a variety of backgrounds, skills, and viewpoints - recognizing that diverse identities strengthen our workplace and the care we can provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging and allyship. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care.

Lurie Children's and its affiliatesare equal employment opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law.

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