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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 00184834 |
Description Activated On: 4/20/2026 2:59:42 PM |
Position Purpose: Describe the primary purpose of this position and how it contributes to the organization’s objectives. Example: Provides clerical and office support within the Division to ensure its operations are conducted efficiently and effectively. This position is located in the Cost Reporting Unit within the Cost Reporting Section of the Division of Financial Reporting, Bureau of Financial Operations. The incumbent is responsible for the planning, directing, and controlling of the Medicare cost reporting process for State mental hospitals, and the cost reporting process for the State youth development centers (YDCs) and youth forestry camps (YFCs). The incumbent has expertise in the proper use of Medicare rules including Title XVIII Medicare cost principles and their application to mental health hospitals. In addition, coordinates development and implementation of computerized cost reporting system and procedures for DHS's YDCs/YFCs. This position is also responsible for review and proper classification of costs at all of the types of facilities noted. The position also provides guidance to the accountants and/or facility financial managers at the State mental hospitals, and YDCs/YFCs. |
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Description of Duties: Describe in detail the duties and responsibilities assigned to this position. Descriptions should include the major end result of the task. Example: Types correspondence, reports, and other various documents from handwritten drafts for review and signature of the supervisor. Coordinates, directs, and assists, when necessary, uniform completion and timely submission of Medicare cost reports for the mental health hospitals to the Federally approved intermediary. Reviews cost reports before their submission to the intermediary. Reviews and analyzes related financial documentation for hospitals, nursing facilities, or other medical institutions in order to ensure accuracy and ensure timely submission of federally mandated documentation. Reviews and interprets Medicare rules and guidelines for allowable expenses; consults with facilities on clarifications on revenue or expenses as necessary. Identifies errors or suspected anomalies in accounting documentation and conducts subsequent investigations by reviewing submissions, respective data, and interviewing financial counterparts of the submitting agency in order to identify potential errors and corrective actions. Consults with representatives of the Federal intermediaries in the status of their review of Medicare cost reports, ensures that these reviews are conducted in a timely and professional manner, contact the intermediary concerning any reports which seem stalled or delayed and provides information or assistance to the intermediary should questions arise during the intermediary's review of cost reports. Assures the maximum revenues possible are received in accordance with applicable cost accounting principles by analyzing the result of all intermediary settlements and audit adjustments for the following: (a) ensures uniform treatment of DHS/MH costs by the intermediary, (b) ensures proper accounting and Title XVIII (HIM15) cost principles were applied to the reports, and (c) formulates responses to any questioned or disallowed costs raised by the intermediary. Negotiates, on behalf of the Department, resolution or revision to the issues of questioned or disallowed costs with the appropriate fiscal intermediary. Formulates Departmental position and defense strategy for any costs questioned or disallowed which cannot be resolved through negotiation. Consults with DHS legal staff to ensure that appeals of intermediary or Centers for Medicare and Medicaid Services (CMS) reviews are filed timely and accurately with the Provider Reimbursement Board (Title XVIII Medicare). Supervises the maintenance of history files of Medicare and Youth Development Centers cost reports, submission dates, audit reviews, issues, and their resolution. Provides cost report information of actual Medicare earnings relative to the Title XVIII income anticipated in the Department's budget. Consults with Budget staff on possible issues or procedures to address in an effort to keep earnings in line with or ahead of budget. Also, uses analysis to seek new or improved techniques to increase Title XVIII Medicare earnings for the Department's mental health hospitals. Create and maintain the Medicare cost report manuals for State mental hospitals and cost apportionment manuals for YDCs/YCFs. These manuals must reflect the proper accounting procedures for the facility accountants to use in preparing their cost reports. Calculate and analyze the per diem rates and unit costs which are used in the development and updating the interim billing rates utilized at YDC/YFC facilities. Reviews YDC audit reports. Prepares responses to audit findings. Coordinates efforts to reach a final settlement with each county, based on the final per diem costs issued by the AG in the audits. Follows current changes in regulations in the Federal Register and Commerce Clearinghouse publications. Researches issues impacting Medicare and YDC revenues. Maintains membership in the National Association of Reimbursement Officers (NARO) and discusses cost reporting problems with contacts in other States. Establishes and maintains a vendor for software required to complete the Medicare reports. Trains accountants to utilize software as required. Provides training to Headquarters and facility staff on applicable accounting principles to ensure compliance with State and Federal statutes, regulations and audit standards, as they relate to Federal funding or cost reporting issues at State mental hospitals and YDCs/YFCs. Prepares correspondence and responds to requests for information. This includes preparing memos, letters, and reports by independent action and at the request of others. Also, performs special analysis of specific problems or issues relating to Medicare or other sources of Federal funds supplied to the MH hospitals or YDC/YFC programs. Conducts a detailed review of the cost report for each facility and corrections of any errors discovered via reclassifications, additions, deletions, or modifications of costs. Discussion with facility accountant regarding any changes with regard to the above is mandatory. Compiles an annual basis data submission for the Pennsylvania Health Care Cost Containment Council (PH4C). This includes Medicare cost report information and any other data elements required in their request. Assists supervisor by performing other job-related duties as assigned. Mandatory overtime may be needed due to crucial projects which need peak hours to complete. Other duties as assigned. |
Decision Making: Describe the types of decisions made by the incumbent of this position and the types of decisions referred to others. Identify the problems or issues that can be resolved at the level of this position, versus those that must be referred to the supervisor. Example: In response to a customer inquiry, this work involves researching the status of an activity and preparing a formal response for the supervisor’s signature. In response to changes in cost reporting requirements, evaluates the options available and decides on the most appropriate way to fulfill the reporting requirements. New procedures and instructions are developed and issued to implement the change. Determines the response and course of action to be taken in reply to issues raised by auditors during Medicare and YDC audits. |
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Requirements Profile: Identify any specific experience or requirements, such as a licensure, registration, or certification, which may be necessary to perform the functions of the position. Position-specific requirements should be consistent with a Special Requirement or other criteria identified in the classification specification covering this position. Example: Experience using Java; Professional Engineer License Experience: Licenses, registrations, or certifications: 1. N/A 2. N/A 3. N/A 4. 5. 6. |
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Essential Functions: Provide a list of essential functions for this position. Example: Transports boxes weighing up to 60 pounds.
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