Reimbursement Specialist

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth.

The Reimbursement Specialist is responsible for managing and ensuring the accuracy and timeliness of Medicare cost report acceptance, tentative and straight-to-final settlements, interim rates, and applicable limits for all providers in the Fiscal Intermediary Shared Systems (FISS). This role helps secure proper reimbursement for Medicare healthcare providers.

• Process cost report correspondence, including mail, cost report submissions, and settlement documentation
• Analyze cost report documentation to determine whether acceptability criteria are met for submission
• Update systems such as FISS and STAR with application data from Provider Enrollment
• Maintain system accuracy by updating rate changes based on payment rate reviews, provider reviews, and CMS-mandated changes
• Build constructive working relationships with internal teams, clients, and customers to meet shared goals
• Collaborate with departments such as Recoupment, Systems Support, Provider Call Center, Provider Audit, Provider Enrollment, PreProcess, and Provider Education to resolve provider issues
• Respond to provider inquiries regarding payments, cost reports, and reimbursement-related topics
• Mentor and support onboarding and development of new and existing staff
• Collaborate with team members to achieve departmental goals and ensure timely task completion
• Contribute to a positive team environment through feedback, process improvement, and participation in team goals