Reimbursement Supervisor

Role:

This position is part of the Reimbursement team in the Global Business Services (GBS). The Reimbursement Supervisor is responsible for overseeing the daily operations and deliverables of the reimbursement team, including the preparation, review, and filing of Medicare and Medicaid cost reports, reimbursement analytics, and regulatory compliance activities. This role provides leadership, subject matter expertise, and quality assurance for all reimbursement reporting processes. 

Essential Job Functions -

• Team Leadership – Supervise reimbursement analysts (both entry-level and senior), managing workflow, resources, and staff development through coaching, training, and performance evaluations.

• Cost Report Oversight – Direct preparation, review, and submission of Medicare and Medicaid cost reports, as well as Coronavirus Aid, Relief, and Economic Security (CARES) Act, Federal Emergency Management Agency (FEMA), and uncompensated care reports, ensuring accuracy, timeliness, and regulatory compliance.
• Audit and Appeals Management – Coordinate cost report audits, appeals, and reopening processes with government agencies and external consultants.
• Regulatory Compliance – Establish internal controls, maintain documentation standards, and monitor rulemaking from the Centers for Medicare & Medicaid Services (CMS) and Medicaid policy changes to advise leadership on strategic implications.
• Technical Review and Approvals – Provide expert review and sign-off on cost reports, supporting schedules, and audit-ready documentation.
• Financial Analysis – Oversee reimbursement modeling, impact analyses, performance monitoring, and financial reconciliations to support enterprise financial planning and decision-making.
• Stakeholder Collaboration – Partner with finance, compliance, and legal teams, and serve as the primary point of contact for United States and Global Business Services (GBS) stakeholders regarding reimbursement matters.
• Payor Policy Management – Supervise documentation and updates of payor payment policies, contracts, and compliance requirements.
• Process Improvement – Lead initiatives to enhance reimbursement processes, revenue cycle management, and provider credentialing and enrollment audits.
• Culture and Performance – Foster a collaborative, high-performance culture aligned with organizational goals, ensuring accountability and continuous improvement.

Qualifications:

• Bachelor's degree in business, Health Administration, or another discipline that provides applicable experience. (required)
• Masters degree in healthcare (preferred)

• Hold medical coding certification in medical terminology - ICD-9 and CPT-4 coding (preferred)
• Certified Public Accountant (CPA) (preferred)

• 5 years' experience in healthcare environment leading provider reimbursement operations. (required)
• 2+ years of direct leadership experience. (required)
• Demonstrated experience preparing and reviewing Medicare and Medicaid cost reports across multiple entities (required)
• Experience managing regulatory audits and appeals processes (required)
• Deep understanding of reimbursement methodologies (PPS, IME/GME, DSH, S-10, UPL, DPP).


Work Setup: Onsite (first 3 months then will transition to hybrid)
Schedule: Night Shift, 9:00 PM-6:00 AM
Location: BGC, Taguig City



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