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Reimbursement Director
2 months ago
We are seeking a highly skilled and experienced Reimbursement Director to join our team at Northeast Georgia Health System, Inc. As a key member of our finance department, you will be responsible for overseeing the coordination of all CMS reporting requirements, including the administration of the Charge Description Master and revenue forecasting for both budget and month-end close.
Key Responsibilities- Supervise and coordinate Charge-master management functions, including researching coding and billing guidelines, researching insurance contracts, and updating hospital Charge-master.
- Work with revenue-producing departments to ensure the ongoing coordinated consistency of the Charge-master, including accurate descriptions, coding, additions, deletions, pricing, charging methodology, and any other changes.
- Collaborate with managerial and supervisory staff to ensure regulatory billing with correct coding on accounts.
- Maintain a working knowledge of revenue cycle process to aid in the implementation of regulatory standards that assist the health system in cash collection while accurately complying with billing guidelines.
- Monitor compliance with corporate, federal, and state guidelines.
- Oversee all cost reporting to CMS for funding for GME programs in cooperation with the Finance Department.
- Work with Finance to perform applicable analyses to understand net revenue effect of proposed Charge-master changes.
- Perform analysis, identify trends, validation of compliance as related to fiscal activities generating additional revenue, reducing bad debt expense and charity write-offs, and overall expense reduction.
- Remain current with updated coding and billing regulations.
- Prepare, monitor, and file Medicare and Medicaid Cost Reports, assuring maximization of reimbursement from third-party payors.
- Respond to surveys affecting Medicare and Medicaid rate revisions, interim payments, and hospital-based physician arrangements.
- Monitor changes and proposed changes to Medicare and Medicaid regulations and determine the financial effect of these changes on the organization.
- Coordinate financial audits conducted by CMS, DCH, and other governmental intermediaries on prior year's cost reports and surveys.
- Provide management for Indigent Care Trust Fund processes and reporting.
- Bachelor's Degree in Business Administration, Finance, Accounting, or other related area.
- Minimum five (5) to seven (7) years relevant work experience in healthcare financial management, including revenue modeling and CMS cost reporting activities.
- Preferred Master's degree or CPA.
- Operational experience as a Director in a health system.
At Northeast Georgia Health System, Inc., we offer a dynamic and supportive work environment, competitive compensation and benefits package, and opportunities for professional growth and development. If you are a motivated and experienced professional looking for a new challenge, we encourage you to apply for this exciting opportunity.
