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. Built on integrity, collaboration, and excellence, we’re more than a service provider—we’re your trusted partner in innovation.
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 position plays a vital role in securing proper reimbursement for Medicare healthcare providers.
Key Responsibilities
Process cost report correspondence, including mail, cost report submissions, and settlement documentation (tentative and final)
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
Required Qualifications
High school diploma
At least 1 year of experience accounting, or healthcare
Strong data entry accuracy
Demonstrated problem-solving skills
Preferred Qualifications
2 years of experience in accounting or healthcare
Effective oral and written communication skills
Strong time management and customer service orientation
High attention to detail and accuracy
Strong critical thinking and analytical abilities
Why Join Us?
Impactful Work: Contribute to Medicare compliance and provider reimbursement, ensuring proper healthcare funding.
Professional Growth: Gain exposure to complex reimbursement models and regulatory compliance in a dynamic healthcare environment.
Collaborative Team: Work with industry experts in a supportive, team-oriented culture.
Benefits:
401(k)
401(k) matching
Dental insurance
Disability insurance
Medical insurance
Life insurance
Flexible Paid time off (FPTO)
Paid Holidays
Background Check Process:
Education, Employment and Criminal (local, federal), 7 years' work history
Drug screen
Fingerprinting for Personal Identity Verification (PIV) Card
Subject to additional background investigations conducted by the Defense Counterintelligence and Security Agency.
Must be eligible, and obtain a PIV card .
What to Expect Next:
After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting.
Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law.
Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).
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 position plays a vital role in securing proper reimbursement for Medicare healthcare providers.
Key Responsibilities
Process cost report correspondence, including mail, cost report submissions, and settlement documentation (tentative and final)
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
Required Qualifications
High school diploma
At least 1 year of experience accounting, or healthcare
Strong data entry accuracy
Demonstrated problem-solving skills
Preferred Qualifications
2 years of experience in accounting or healthcare
Effective oral and written communication skills
Strong time management and customer service orientation
High attention to detail and accuracy
Strong critical thinking and analytical abilities
Why Join Us?
Impactful Work: Contribute to Medicare compliance and provider reimbursement, ensuring proper healthcare funding.
Professional Growth: Gain exposure to complex reimbursement models and regulatory compliance in a dynamic healthcare environment.
Collaborative Team: Work with industry experts in a supportive, team-oriented culture.
Benefits:
401(k)
401(k) matching
Dental insurance
Disability insurance
Medical insurance
Life insurance
Flexible Paid time off (FPTO)
Paid Holidays
Background Check Process:
Education, Employment and Criminal (local, federal), 7 years' work history
Drug screen
Fingerprinting for Personal Identity Verification (PIV) Card
Subject to additional background investigations conducted by the Defense Counterintelligence and Security Agency.
Must be eligible, and obtain a PIV card .
What to Expect Next:
After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting.
Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law.
Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).