OhioHealth · 3 weeks ago
Senior Medicaid & Medicare Reimbursement Consultant
Columbus, OH
Full-time
Onsite
Mid, Senior Level
4+ years expOhioHealth is a health system dedicated to wellness and guiding individuals towards health. The Senior Medicaid & Medicare Reimbursement Consultant is responsible for preparing and reviewing cost reports, ensuring appropriate reimbursement, and leading various reimbursement financial projects while supervising the Reimbursement Analyst's work.
Health Care
Responsibilities
This position will be responsible for ensuring the appropriate governmental (Medicare and Medicaid) reimbursement is received for OhioHealth
This position is primarily responsible for the proactive calculations and modeling of new regulatory changes and impacts as well as variance analysis of third-party liability accounts
Provides supporting work papers and documentation for third-party inquiries
This position has supervisory oversight of the Reimbursement Analyst daily work schedule including flow of information, teaching of reimbursement fundamentals and principles, review of work and setting daily priorities
This position supports the Director of Revenue and Reimbursement and Manager of Reimbursement with many special analyses throughout the year associated with revenue cycle, charge analysis, regulatory and financial reporting
The Senior Reimbursement Consultant will be a subject matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical Education, and Governmental Logs, (HCAP, UPL and Franchise Fee programs in the state of Ohio) as well as special projects as assigned
Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining up to date with all regulatory requirements, both federal and state is required
The Reimbursement Consultant position leads, advises and consults various reimbursement financial projects, as well as special projects throughout the year and needs to be able to delegate direct reports assigned to the project or process while staying connected to both the pertinent details as well as the high level strategic purpose
The Senior Reimbursement Consultant is required to use extensive interpersonal skills in communicating with all management levels at OhioHealth
This role functions in a heavily matrixed environment and requires strong prioritization, communication and planning skills
Consulting and oversight of key areas at OhioHealth in the central Ohio facilities as well as non-central Ohio facilities in the reimbursement functions
Knowledge in the following areas: Subject matter expert on CMS cost reporting, disproportionate share (DSH), Uncompensated Care, Bad debt reporting, IME/GME, Medicare Wage Index, S-10 reporting, Tricare and 855’s, Ohio Medicaid, HCAP, UPL and Franchise Fee programs
Knowledge of Acute Care Hospitals, Critical Access Hospitals, Sole Community Hospitals and Rural Health Clinics
Knowledge of reimbursement in specialty areas such as psych, inpatient rehabilitation units, Home Health and Hospice
Projects as assigned by Director of Revenue and Reimbursement and Manager of Reimbursement
Provide Director of Revenue and Reimbursement and Manager with updates
CGS audits and auditors Working with our legal vendor for Medicare Appeals
Working with OHA and CBSA facilities on wage index opportunities
Special projects / analysis as assigned by the Director of Revenue and Reimbursement and Manager of Reimbursement
Qualification
Required
Bachelor's Degree: Finance (Required)
BS or BA in Accounting or Finance
Hospital and/or healthcare industry experience
Understanding of the CMS prospective payment system and State of Ohio regulations
Minimum of 4 years' experience in the healthcare industry
Strong team development and delegations skills
Excellent communication and presentation skills
Proficiency in Microsoft applications
Knowledge of clinical & financial patient management systems
Demonstrated ability in financial analysis and cost reporting
Preferred
CPA, MHA or MBA
Experience with Medicare/Medicaid cost reporting 4 - 6 years as a Sr. Reimbursement Analyst or similar position(s)
Company
OhioHealth
The largest integrated healthcare delivery network in central Ohio.
10001+ employees
H1B Sponsorship
OhioHealth has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (70)
2024 (14)
2023 (5)
2022 (1)
2021 (8)
2020 (9)
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Parkinson's Foundation
2024-10-14Acquired
2023-07-25Grant
Leadership Team
L
Lora Montgomery
Operations Manager, Service Excellence
Yvonne Rayburn
Digital Marketing Manager
Recent News
2025-12-10
2025-12-02
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