Description: The Reimbursement Specialist directs development & illustrates the impact of proposed & final Federal/State regulations to staff and senior Management.

• Directs the preparation of reimbursement studies as needed by senior management.
• Researches regulations related to the implementation of new programs, services, & ventures. Researches regulations developing techniques for maximizing reimbursement.
• Directs the development of contractual allowances for budget projections & monthly & year-end financial statements.
• Manages & directs the preparation and/or review of preliminary & filed Medicare/Medicaid cost reports.
• Directs the evaluation of interim payments from third-party payors for accuracy & adequate cash flow.
• Coordinates with Information Systems the production of reports for cost reporting/cost analysis purposes.
• Reviews generally accepted accounting principles & auditing standards as they apply to the reimbursement area.
• Develops & conducts reimbursement seminars for staff of IHS operating units.
• Reviews of Medicare/Medicaid settlements for accuracy & impact on reimbursement for all IHS entities.
• Coordinates the support & documentation needed by independent & Medicare & Medicaid auditors.
• Manages, directs & develops Medicare/Medicaid appeals.
• May perform additional duties as assigned.