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Reimbursement and Revenue Management Director

2 months ago

Gainesville, Florida, United States Northeast Georgia Health System Full time

About This Role

As a Reimbursement and Revenue Management Director, you will play a pivotal role in ensuring the financial health of our organization. You'll lead a team dedicated to optimizing revenue streams, managing complex reimbursement processes, and staying ahead of evolving regulatory landscapes.

Key Responsibilities

  • Charge Description Master (CDM) Oversight: You will oversee the development, implementation, and maintenance of our CDM, ensuring accuracy, compliance, and alignment with industry best practices.
  • Revenue Forecasting and Analysis: You'll collaborate with finance teams to develop accurate revenue forecasts, analyze trends, and identify opportunities for improvement.
  • CMS Reporting and Compliance: You will be responsible for all CMS reporting requirements, including cost reporting for Graduate Medical Education (GME) programs. Your expertise in regulatory changes will guide our organization's response to evolving healthcare finance policies.
  • Billing and Coding Expertise: You possess a deep understanding of CPT/HCPCS, UB-92 Revenue Coding, modifiers, billing regulations, DRGs, and APCs. This knowledge will be instrumental in ensuring accurate billing practices and maximizing reimbursement.
  • Team Leadership and Collaboration: You'll lead and mentor a team of professionals, fostering a collaborative environment that drives excellence in revenue management.

Qualifications

We seek a highly motivated and experienced professional with a proven track record in healthcare finance. A Bachelor's degree in accounting, finance, or a related field is required, along with significant experience in reimbursement, revenue cycle management, and CMS reporting.