Director of Reimbursement
4 weeks ago
At Gundersen Health System, we are seeking a highly skilled and experienced Director of Reimbursement to lead our third-party reimbursement efforts. As a key member of our finance team, you will be responsible for overseeing all aspects of reimbursement processes, ensuring compliance with Medicare and Medicaid regulations, and optimizing reimbursement strategies.
Key Responsibilities:- Oversee monthly contractual allowance and reserve analysis for all third-party payers
- Responsible for month-end financial analysis of revenue, contractual allowances, and bad debt
- Prepare estimated cost report settlements to support the month-end close process
- Review cost report preparation and other information as required by federal and state laws, as well as other third-party contractors
- Support third-party contract negotiations through detailed analysis, related costs, and charges, and assess the impact of managed care contracts on reimbursement and contractual allowances
- Maximize reimbursement activities, wage index, especially as it relates to programs such as critical access hospital/rural health centers and other government programs
- Responsible for the preparation of client-prepared work papers and supporting documentation related to the year-end audit of contractual allowances, reserves, and settlements
- Support external auditor requests
- Develop the annual budget assumptions for contractual allowances, charity care, and bad debt
- Review and assess the financial impact of proposed and passed state and federal legislation
- Assist in the preparation of the annual Form 990, Schedule H
- Act as the liaison to fiscal intermediaries and other auditors regarding reimbursement matters
- Develop and implement improvement opportunities for efficient third-party reimbursement function
- Direct and manage the reimbursement team
- Lead, support, and guide the larger finance team (including CAH Finance Administrators) in reimbursement issues, special projects, and optimization efforts
- Bachelor's degree in Accounting, Finance, or related field
- 10+ years' experience in healthcare, finance, or public accounting is preferred; as well as experience with third-party reimbursement, cost reports, etc.
- Preference to those with experience in critical access hospital/rural health system reimbursement, ideally within an integrated healthcare system
- Tailored Benefits Package: We offer a comprehensive benefits package that varies based on your location. To learn more about the specific benefits available in your area, please inquire with the recruiter during the application process.
- Flexible work location: While this role offers some flexibility in work location, candidates must reside within a reasonable commuting distance of La Crosse or Green Bay, WI due to frequent on-site needs.
At Gundersen Health System, we believe in leading with love and fostering a culture of belonging and excellence. If you share our values and are looking for an opportunity to make a significant impact on our workforce, we invite you to submit your application.
ONE SYSTEM, ONE VISION: Gundersen Health System is a large and growing health system with a strong presence in the region. We operate 11 hospitals, more than 100 clinics, and employ over 14,000 teammates across 35 counties in 4 states.
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