Medicare Part A Institutional Reimbursement Expert for Provider Reimbursement Review Board

Centers for Medicare & Medicaid Services • Woodlawn, MD • 6d ago

Summary The Centers for Medicare and Medicaid Services (CMS) seeks candidates, including accountants and attorneys, to fill a vacant position on the Provider Reimbursement Review Board (PRRB). The PRRB is an independent five-member panel that adjudicates disputes over institutional reimbursement matters in the Medicare program. Responsibilities Serves as a Member of the five Member Provider Reimbursement Review Board, which adjudicates adversarial disputes over institutional reimbursement matters in the Medicare program. Participates in hearings and decision conferences; reviews, writes, and edits decisions; develops the administrative record; and timely handles case management and disposition activities. Supports the Board Chairperson's distribution of work, including monitoring progress to meet goals in timely issuing decisions and providing, as appropriate, feedback and updates on status. Ensures the integrity and impartiality of the PRRB's administrative process. Maintains collegial relationships with fellow Board Members, Board Advisors and other Office of Hearings management and staff. Requirements Conditions of Employment Qualifications Candidates must be knowledgeable in the field of Medicare Part A reimbursement and Medicare payment of providers. Ideal candidates will have experience in Medicare Part A payment matters, administrative or judicial review, health law and/or Medicare cost reports. References will be requested. An example of a candidate's written work product may be requested. Education This job does not have an education qualification requirement. Additional Information PRRB Members are appointed to a three-year term by the Secretary of the Department of Health and Human Services, with the possibility of reappointment for two additional terms of three years in length. Service on the PRRB offers substantial responsibility and work that is intellectually engaging and professionally rewarding. The matters that come before the PRRB often involve complex or novel legal questions and decisions issued by the PRRB are commonly litigated in Federal court and on occasion reach the U.S. Supreme Court. Veteran's Preference does not apply to the PRRB. This position does not confer non-competitive conversion to the competitive service. Acceptance of an excepted service appointment from applicants in the competitive service will require a written statement of understanding when voluntarily leaving the competitive service. PRRB Members must reside in the Baltimore, Maryland commuting area, which includes the surrounding localities in which people live and can reasonably be expected to travel back and forth daily. Workplace Flexibility at CMS: This position has a regular and recurring reporting requirement to the CMS office listed in this announcement. CMS offers flexible working arrangements and allows employees the opportunity to participate in alternative work schedules at the manager's discretion.

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