Medical College of Wisconsin · 3 hours ago
Reimbursement Manager / GME
Milwaukee, WI
Full-time
Hybrid
Senior Level
5+ years expThe Medical College of Wisconsin is responsible for providing information and documentation needed to optimize GME and IME reimbursement for its affiliated hospitals. The Reimbursement Manager will work closely with various stakeholders to manage and evaluate reimbursement systems, ensure compliance with CMS regulations, and improve processes related to GME funding.
EducationHigher EducationMedical
Responsibilities
Maintain a thorough knowledge of current and pending Centers for Medicare and Medicaid Services (CMS) rules and regulations concerning GME and IME reimbursement
Implement changes to existing systems as necessary to improve efficiency and effectiveness or to respond to changing CMS rules and clarifications
Develop, manage, and evaluate processes for standardized approaches to systems that will optimize GME reimbursement for the affiliated hospitals
Maintain effective working relationships with Department Administrators, Program Directors, and Education Coordinators for the 100+ MCWAH accredited residency and fellowship programs
Utilize the ACGME Accreditation Data System (ADS) in order to review program complements and hospital rotation sites
Develop a thorough knowledge of the Health Financial Systems (HFS) and the iRotations systems that are used to manage GME reimbursement reporting systems. Work as a liaison with vendors to address performance issues or to recommend needed changes
Learn and maintain the relationship between the affiliated hospitals and the residency/fellowship FTE they support
Become knowledgeable on program funding requests and obtaining approvals from key leadership as needed
Manage current systems regarding the quarterly flow of rotation and assignment information from the residency/fellowship programs. Evaluate and look for process improvements
Audit quarterly rotation submissions from the residency/fellowship coordinators. Train and oversee the work of the MCWAH staff that assist with the quarterly audits
Hold quarterly meetings with MCWAH staff to discuss the previous quarter’s audits
Monitor the results of CMS and HRSA audits at the affiliated hospitals and implement changes to address deficiencies in our current documentation practices
Provide training to all new program coordinators and MCWAH staff who will be using the iRotations collection system
Oversee the collection, analysis, dissemination, and maintenance of source documentation from our residency and fellowships that is needed by hospitals to meet their Medicare audit requirements
Manage and track the online record-keeping system to ensure audit-related documentation will be maintained and will be available to our hospitals in a timely manner
Create annual IRIS reports using HFS and provide these reports to the hospitals at the appropriate times
Maintain liaison with key hospital staff to discuss common issues concerning GME reimbursement
Provide additional documentation that may be requested by the Medicare Contractor. This could be support for FTE claimed, non-MCWAH rotators, duplicate FTE, ECFMG certificates, and more
Collaborate with VA and MCWAH staff to resolve any VA timesheet issues, complete the annual VA funding agreement, and review changes in FTE support requested from the programs
Provide analysis of future GME funding needs that are a result of requests from individual programs
Work with the affiliated hospitals consultants as needed
Manage other finance-related projects as requested by the DIO and/or GME Administrator
Qualification
Required
Bachelor's degree
5 years of experience
Strong working knowledge of clinic operations, reimbursement practices, procedure coding/use of modifiers and monitoring of reimbursement trends
Ability to handle multiple tasks simultaneously
Working knowledge of insurance/managed care
Excellent written and verbal communication skills
Problem-solving skills
Professional and confident demeanor
Experience with Excel, Word and IDX
Knowledge of quality control, customer service standards, information management, procedural process, and recordkeeping
Computer, technical, interpersonal, oral communication, listening, and patience skills
Preferred
Accounting experience
Any combination of 5 years of hospital experience and/or Medicare audit experience
Expertise in GME and IME reimbursement and/or Medicare audit experience
CPA
Benefits
Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
403B Retirement Package
Competitive Vacation and Paid Holidays offered
Tuition Reimbursement
Paid Parental Leave
Employee & Family Assistance Program (EFAP)
Pet Insurance
On campus Fitness Facility, offering onsite classes
Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.
Company
Medical College of Wisconsin
Medical College of Wisconsin is a school in Milwaukee.
5001-10000 employees
Funding
Current Stage
Late StageTotal Funding
$22.7MKey Investors
US Department of Commerce, Economic Development AdministationNational Institutes of HealthPaula and Rodger Riney Foundation
2024-07-03Grant
2023-08-17Grant
2022-08-25Grant· $5.9M
Leadership Team
John R. Raymond
President and CEO
Recent News
Business Wire
2025-11-05
2025-11-03
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