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Director of Reimbursement

4 months ago


Stamford, United States Atlantic Partners Full time

Job Description:

The company is looking for a Full-time Director of Reimbursement for the Finance Department.

This position is Monday-Friday from 9am-5pm. Hybrid role. Must be available to come on site a minimum of 3 days a week.

The Director of Reimbursement is primarily responsible for the financial planning, evaluation and reporting functions of the Health System including third party reimbursement, and special projects. Responsible for the completion and analysis of the Medicare, Medicaid, OHCA and other third-party cost reports and reporting. This position will be responsible for reviewing, maintaining and keeping management updated on all relative systems, payer and internal issues that impact the revenue cycle. This position will be responsible for the month-end close process pertaining to net accounts receivable. This position will collaborate with revenue cycle to review, revise, adjust and reconcile proration rules and other patient service components as necessary. The Director will also work closely with managed care to ensure proper reimbursement is being realized.

Responsibilities:

Reviews cost reimbursement reports submitted to government and private third-party agencies (Medicare, Medicaid cost reports and Office of Health Care access filings).

Oversee the annual budget process associated with the expected changes for all third-party reimbursement.

Oversee the completion and analysis of month end statistical reporting.

Develops and maintains projection models to be used in five-year financial modeling for the Health System.

Develops and maintains cost accounting and productivity monitoring systems to be used in reimbursement applications and to assist in contract negotiations and evaluations.

Collaborate with Revenue cycle and Managed Care to ensure proper accounts receivables valuation, denial management and bad debt analysis.

Evaluates contractual arrangements with insurance providers and assists in monitoring profitability of those agreements entered into.

Assists in the certificate of need process; accumulates and reviews data prior to submission of CON.

Financially evaluates new or existing operating programs.

Keeps abreast of all standards to ensure compliance with orders or directives issued by duly constituted governmental/regulatory or third-party payers.

Qualifications:

Master's Degree with a major in accounting or equivalent is required.

Must have Healthcare Experience

A minimum of 3-5 years' experience in a leadership capacity is required.

Demonstrated ability to provide vision and leadership

Superior communication skills, both written, verbal and presentation skills to effectively address all levels within the organization.

Detail oriented, logical and methodological approach to problem solving

High level of competency with computers, the Internet, and computer software such as MS Office or equivalent is required. Knowledge ACCOUNTING SOFTWARE Meditech (or equivalent) is required.

Superior verbal, written, organizational, and interpersonal skills are required.

Prior experience designing training programs, developing training materials and facilitating presentations to large audiences and varying levels of an organization is required

The ability to work with individuals at all organizational levels, particularly peers, team members, other departments, patients, and the community is required.