Orlando Regional Healthcare

Director, Medicare/Medicaid Reimbursement

Orlando Regional Healthcare • $120K — $150K *
Orlando, FL 32828In-Person
Healthcare
8 - 10 years of experience
Reposted 1 week ago
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Accounting, Finance, or Business Administration.
  • CPA required.
  • Over ten years in a leadership role in a complex health system.
  • Strong knowledge of IME, GME, and provider-based reimbursement rules.
  • Experience with Medicare/Medicaid cost reports and audit processes.

Responsibilities

  • Oversee financial analysis and reporting for hospital reimbursement activities.
  • Ensure compliance with current regulations and company policies.
  • Educate executives on various reimbursement rules and impacts.
  • Identify and optimize opportunities for enhancing hospital reimbursement.
  • Review and validate accuracy of cost reports and financial documents.
  • Develop reimbursement skills within the staff for long-term capacity building.
  • Collaborate with leaders on strategic initiatives affecting reimbursement.

Benefits

  • Comprehensive health benefits package.
  • Opportunities for professional development and continuing education.
  • Supportive work environment focused on leadership growth.
  • Participation in strategic healthcare initiatives.
  • Access to wellness programs and employee resources.
Full Job Description
Position Summary

Responsible for oversite of financial analysis, processes, accounting, and reporting for reimbursement activities for system hospitals.
  • Maintain knowledge of current regulations and assure the company is in compliance with them.
  • Provide executives education on IME, GME, Provider Based rules, rural status.
  • Provide system with ongoing financial oversight in reimbursement.
  • Review Medicare/Medicaid cost reports with emphasis on accurate reimbursement to hospital.
  • Review staff completion of all time studies, rotation schedules, statistics and bad debt logs, throughout the fiscal year that are used to complete the annual cost reports.
  • Identifies opportunities to optimize reimbursement including capturing 340B discounts, combining or separating provider numbers.
  • Review monthly close for third party settlement accounts and make sure each hospital is accurately reserved.
  • Review staff responses to Medicare/Medicaid Intermediary to settle various cost report audits each year.
  • Review the Champus Capital and GME Cost report for each hospital.
  • Review year end Medicare Settlement schedules to maintain proper third-party liability accounts.
  • Review third party reimbursement packages for external audit each year.
  • Maintains compliance with all Orlando Health policies and procedures.
  • Monitor wage index areas for geographical reclassifications to enhance reimbursement to each hospital.
  • Develop Reimbursement skills in staff.
  • Review annual IPPS, OPPS rules to find reimbursement opportunities for the system.
  • Provide executive summary of changes in reimbursement impact to system to senior leaders
  • Review LIP, and DPP schedule prepared by staff, ensure accuracy to achieve maximum allowable reimbursement.
  • Review provider-based attestations for OP centers created with expansion of the system.
  • Participates with other functional leaders on strategic initiatives to incorporate regulatory reimbursement concerns.

Bachelor's degree in Accounting, Finance or Business Administration.

CPA preferred.

Ten (10) plus years in a leadership role in a complex health system.

About Orlando Regional Healthcare

Orlando Health is a not-for-profit healthcare organization with multiple facilities in the Orlando, Florida area. The organization includes Orlando Regional Medical Center, Arnold Palmer Hospital for Children, Winnie Palmer Hospital for Women & Babies, Dr. P. Phillips Hospital, South Seminole Hospital, and Health Central Hospital. Orlando Health was founded in 1918 and is headquartered in Orlando, Florida. The organization provides a wide range of medical services, including cancer care, cardiology, emergency care, neurology, orthopedics, pediatrics, and women's health.
Learn more about Orlando Regional Healthcare
Size
20,000 employees
Industry
Healthcare
* Ladders Estimates

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