ALIYA Healthcare Consulting · 20 hours ago
Reimbursement Consultant
Chicago, IL
Full-time
Onsite
Mid Level
$120K/yr - $140K/yr
3+ years expALIYA Healthcare is seeking an experienced Reimbursement Consultant to support and optimize reimbursement across their skilled nursing operations. This role is responsible for ensuring accurate reimbursement, regulatory compliance, and revenue integrity through analysis, reporting, and collaboration with clinical, billing, and finance teams.
Health CareNursing and Residential CareRehabilitation
Responsibilities
Analyze and monitor reimbursement across Medicare, Medicaid, and Managed Care payers
Support Medicare Part A reimbursement, case mix, PDPM, and RUG/UG or state-specific methodologies as applicable
Review MDS assessments and clinical documentation to ensure accurate reimbursement capture
Identify reimbursement risks, trends, and opportunities for improvement
Assist with rate reviews, audits, appeals, and cost report preparation
Collaborate with clinical, billing, finance, and operations teams to resolve reimbursement issues
Ensure compliance with CMS, state, and payer regulations
Provide education and guidance to facility leadership and clinical teams on reimbursement best practices
Prepare reports, dashboards, and executive summaries related to reimbursement performance
Support survey readiness and respond to reimbursement-related inquiries from auditors and regulators
Qualification
Required
3+ years of experience in healthcare reimbursement, preferably in skilled nursing or post-acute care
Strong knowledge of Medicare, Medicaid, and Managed Care reimbursement
Experience with MDS, PDPM, case mix, and revenue optimization strategies
Proficiency with healthcare systems such as PCC (PointClickCare) or similar platforms
Strong analytical, organizational, and problem-solving skills
Excellent communication skills with the ability to work cross-functionally
Ability to manage multiple priorities in a deadline-driven environment
Company
ALIYA Healthcare Consulting
Raising the bar on quality care. Provide care and prove quality to enhance and rehabilitate our residents.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Flora Reznik
CFO
Brandy Gregory, BSN, RN
Chief Nursing Officer
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