Director of Reimbursement

4 weeks ago


La Crosse, Wisconsin, United States Gundersen Health System Full time
Director of Reimbursement

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
Requirements:
  • 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
Why Gundersen Health 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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