Reimbursement Specialist

Salary: $89,965.00 - $115,094.00 Annually

Location : Washington, DC

Job Type: Full-Time

Job Number: 24-FI-HSSC-0002

Department: Human Support Services Cluster

Division: HSSC-Department of Health Care Finance

Opening Date: 10/13/2023

Closing Date: Continuous

Job Details SERVICING PERSONNEL OFFICE/UNIT: Office of Human Resources
POSITION SERIES: DS - 501
POSITION GRADE: DS-12
IF "OPEN UNTIL FILLED," FIRST SCREENING DATE: October 27, 2023
TOUR OF DUTY: To Be Determined
AREA OF CONSIDERATION: Unlimited
PROMOTION POTENTIAL: None
NO.
OF VACANCIES: One (1) or more
AGENCY: Human Support Service Cluster (HSSC), Department of Health Care Finance (DHCF)
DURATION OF APPOINTMENT : Permanent
COLLECTIVE BARGAINING UNIT: This position is not in a collective bargaining unit.

BRIEF DESCRIPTION OF DUTIES: This position is located within the Office of the Chief Financial Officer (OCFO),Human Support ServicesCluster (HSSC), Department of Health Care Finance (DHCF).
The Reimbursement Specialist coordinates, monitors, and performs various functions related to, the analysis, identification, interpretation, reporting and resolution of provider reimbursement information and claims.
Duties include, but are not limited to: monitoring cost reports and supporting documentation; researching, reviewing, and providing interpretation on federal and local rules and Medicaid policies; reviewing submitted audited cost reports and providing information to audit contractors on policies and procedures; searching for variances from prior periods and looking for trends in cost reporting data; reviewing audited cost reports and responding to questions regarding cost reports; providing documentation, explanations, and testifying as a government witness to assist DHCF legal staff with appeals before the Office of Administrative Hearings and the District courts; communicating and responding to questions regarding healthcare provider taxes; and providing schedules, analysis, work papers, and explanations for the Medicaid Year End Accrual.
Performs other duties as assigned.
Minimum Qualifications

Four (4) years of progressive experience performing the related duties and responsibilities such as reviewing, analyzing, auditing cost reports and financial statements; developing comprehensive oral and written reports; and assisting in the preparation and delivery of oral briefings and testimony.
Healthcare industry experience preferred.
Specialized Experience

Experience that provides the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled.
To be creditable, specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression for this position.

Additional Information COVID-19 VACCINATION:

The Office of the Chief Financial Officer values the safety of our employees, our residents, and our visitors.
In support of these values, OCFO employees are strongly encouraged to be immunized against COVID-19.


COLLECTIVE BARGAINING UNIT:

Employment with the OCFO is at will.
However, the discipline and/or discharge of bargaining unit employees is governed by the collective bargaining agreement.


EEO STATEMENT:

The OCFO is an Equal Opportunity Employer.
All qualified candidates will receive consideration without regard to race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, physical handicap, or political affiliation.


HOW TO APPLY:

All Applicants, including departmental employees and other DC Government Employees, must submit an OCFO employment application at .
(Resume may be attached).
Incomplete applications will not be considered.
Employees affected by restructuring must submit their application with the application transmittal form.
All applications, transcripts, and supporting documents must be received by close of business (5:00 PM) on the closing date of the announcement or they will not be considered.


NOTE: It is imperative that all information on the employment application, resume and supporting documents be both accurate and truthful and is subject to verification.
Misrepresentations of any kind may be grounds for disqualification for this position or termination.


JOB OFFERS:

Official job offers are made only by the OCFO's Office of Human Resources.


PHYSICAL EFFORT:

Sedentary

REASONABLE ACCOMMODATION REQUESTS:

If you are scheduled for an interview and require any reasonable accommodation in our interview process, please inform the hiring representative who contact you to schedule your interview.
Whenever possible, please give the hiring representative sufficient time to consider and respond to your request.


RESIDENCY PREFERENCE:

An external applicant for a position in the OCFO who is a bona fide resident of the District of Columbia at the time of application, may claim a hiring preference over a non-resident applicant by completing the 'Residency Preference for Employment' form, , and uploading and attaching it to their employment application.
To be granted preference, an applicant must: (1) be qualified for the position; and (2) submit a claim form at the time of application.
Except for employees entitled by law to preference, preference will not be granted unless the claim is made at the time of application.
This preference is only granted upon initial appointment.


NOTICE OF NON-DISCRIMINATION:

In accordance with the D.C. Human Rights Act of 1977, as amended, D.C. Official Code section 2-1401.01 et seq., (Act) the District of Columbia does not discriminate on the basis of actual or perceived: race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, familial status, family responsibilities, matriculation, political affiliation, disability, source of income, or place of residence or business.
Sexual harassment is a form of sex discrimination, which is also prohibited by the Act.
In addition, harassment based on any of the above, protected categories is prohibited by the Act.
Discrimination in violation of the Act will not be tolerated.
Violators will be subject to disciplinary action.


NOTICE OF BACKGROUND INVESTIGATION AND PENALTIES FOR FALSE STATEMENTS:

Employment with the OCFO is subject to the completion and satisfactory result of a background investigation conducted by the OCFO.
For most positions, the investigation is conducted after commencement of duty, at which time you will be provided background and release of information forms to complete.
For more information, see the Employment Opportunities section at the OCFO website ().
Certain highly sensitive positions however warrant completion of the OCFO background investigation prior to commencement of duty.
You will be informed if this is required.

Applicant understands that a false statement on any part of your application, including materials submitted with the application, may be grounds for not hiring you, or for firing you after you begin work (D.C. Official Code, section 1-616.51 et seq.)
(2001).
The applicant understands that making a false statement on the application or on materials submitted with the application is punishable by criminal penalties pursuant to D.C. Official Code, section 22-2405 et seq.
(2001).

SALARY REDUCTION OF REEMPLOYED ANNUITANTS:

An individual selected for employment in the District Government on or after January 1, 1980, who is receiving an annuity under any District government civilian retirement system, shall have his or her pay reduced by the amount of annuity allocable to the period of employment as a reemployed annuitant.


VETERANS PREFERENCE:

Applicants claiming veteran's preference must submit official proof with the application.


WORKING CONDITION:

Office Environment

The OCFO offers a competitive salary and benefits package may include the following options:
Medical/Dental/Vision Insurance Coverages Flexible Spending Accounts Aflac Supplemental Insurance Retirement Plans (401K, 403(b) & 457(b)) Group & Optional Life Insurance Short & Long Term Disability Insurance Leave Accrual Options Family Leave Program 11 Paid Holidays per year Employee Assistance Program Employee Commuter Benefits Educational Assistance College Savings Plan Alternate Work Schedules (AWS) Telework For additional details regarding benefits offered by the OCFO, please visit the OCFO's benefits webpage.


01

Describe your experience working in a regulated/regulatory environment and knowledge of reimbursement principles and practices, and cost reporting.


02

Describe your experience analyzing healthcare claims and cost data.


03

Describe your experience working independently and with a team in a fast-paced and high-volume environment with emphasis on accuracy and timeliness.


Required Question