Reimbursement Manager

Centura Health   •  

Englewood, CO

Industry: Patient Care

  •  

8 - 10 years

Posted 335 days ago

Job Description/Job Posting ID: 110890



Recruiter Contact: Darci Clark, Darciclark@centura.org



Schedule: Full Time



Shift: Days

Position Summary



Reimbursement consultant to the hospitals. Manage the cost report process from work paper set preparation to cost report filing including engaging all hospital personnel or consultants to ensure meeting necessary deadlines. Will also file assigned hospital cost reports. Manage all aspects of Medicare audit support and adjustment review including filing Medicare appeals. Manage Medicare and Medicaid reimbursement projects with hospital and corporate senior management, including regulatory research and financial analysis. Responsible for the hospital’s current year Medicare/Medicaid cost report estimate model and prior year cost report balances. Reports to Reimbursement Director.



Minimum Education Requirements



Bachelors in Accounting or Finance MBA Desired



Minimum Experience Requirements



Seven years of healthcare reimbursement/finance experience Strong Excel skills



License/Certifications



CPA Desired



Position Duties (essential functions denoted with an *)



COST REPORTING:



Manage the cost report process including meeting with hospital financial staff prior to the end of the Medicare FYE, overseeing workpaper set completion, cost report preparation and filing including coordination with consultants.*



Manage the Medicare and Medicaid audit process including ensuring supportable documentation is provided to auditors.*



File cost report appeals and complete position papers for the PRRB.*



Deadline driven processes, so must be able to complete timely and accurately.*



REGULATORY:



Strong ability to read and interpret government regulations.*



Consult and advise CFOs, hospital and corporate senior management requests for information and financial impacts to the Medicare and Medicaid programs.*



Write regulatory communication summaries to hospital and corporate finance senior management.*



Manage 855A application filing process through Medicare/Medicaid and CMS review process.*



FINANCIAL REPORTING:



Understand the Medicare and Medicaid cost report estimate model including the factors/data input in the model and their impact.*



Complete quarterly reviews and communicate financial impact of contractual model and supporting documentation.*



Thoroughly understand the hospital’s current and prior year Medicare and Medicaid balance sheet accounts.*



Evaluate P&L impact analysis of cost report settlements and communicate to hospital and corporate finance.*



LEADERSHIP:



Lead training and education sessions for Reimbursement Dept Staff.*



Reimbursement knowledge resource for Reimbursement Dept Staff.*



Work with Reimbursement Director to update policies and procedures.*



Review work projects completed by Reimbursement Analysts.*



Physical Requirements



Sedentary Work - prolonged periods of sitting and exert/lift up to 10 lbs. force