Reimbursement Director

6 days ago


Gainesville, Georgia, United States Northeast Georgia Health System Inc Full time
Job Summary

Under the general direction of the Executive Director, Corporate Controller, we are seeking a highly skilled Reimbursement Director to coordinate all CMS reporting requirements, including oversight of the GME reporting functions. This individual will also be responsible for the administration of the charge description master and revenue forecasting for both budget and month-end close.

Key Responsibilities
  • Oversight of Charge Description Master functions and reimbursement analysis
  • Supervision and coordination of Charge-master management functions in researching coding and billing guidelines, researching insurance contracts, and updating hospital Charge-master
  • Works 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
  • Collaborates with managerial and supervisory staff to ensure regulatory billing with correct coding on accounts
  • Maintains 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
  • Monitors compliance with corporate, federal, and state guidelines
  • Oversees all cost reporting to CMS for funding for GME programs in cooperation with the Finance Department
  • Works with Finance to perform applicable analyses to understand net revenue effect of proposed Charge-master changes
  • Performs analysis, identifies trends, validation of compliance as related to fiscal activities generating additional revenue, reducing bad debt expense and charity write-offs, and overall expense reduction
  • Remains current with updated coding and billing regulations
  • Prepares, monitors, and files Medicare and Medicaid Cost Reports assuring maximization of reimbursement from third-party payors
  • Responds to surveys affecting Medicare and Medicaid rate revisions, interim payments, and hospital-based physician arrangements
  • Monitors changes and proposed changes to Medicare and Medicaid regulations and determines the financial effect of these changes on the organization
  • Coordinates financial audits conducted by CMS, DCH, and other governmental intermediaries on prior year's cost reports and surveys
  • Provides management for Indigent Care Trust Fund processes and reporting
Requirements
  • 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
  • Operational experience as a Director in a health system
About Northeast Georgia Health System Inc

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.



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

    Job SummaryUnder the general direction of the Executive Director, Corporate Controller, the Reimbursement Director is responsible for the coordination of all CMS reporting requirements, including oversight of the GME reporting functions. This role also involves the administration of the charge description master and revenue forecasting for both budget and...


  • Gainesville, Georgia, United States Northeast Georgia Health System, Inc Full time

    Job SummaryThis position reports to the Executive Director of Hospital Revenue Cycle Operations and is responsible for developing, implementing, coordinating, and managing the Revenue Integrity department. Ensures the overall consistency and integration of integrity activities throughout the organization.Key ResponsibilitiesDevelops, coordinates, implements,...


  • Gainesville, Georgia, United States Northeast Georgia Health System, Inc Full time

    Job SummaryThis position reports to the Executive Director of Hospital Revenue Cycle Operations and is responsible for developing, implementing, coordinating, and managing the Revenue Integrity department. Ensures the overall consistency and integration of integrity activities throughout the organization. Develops the alignment of the revenue integrity...


  • Gainesville, Georgia, United States PruittHealth Full time

    Job Title: Hospice Certified Nursing AssistantJob Summary:PruittHealth Hospice is seeking a compassionate and skilled Certified Nursing Assistant (CNA) to join our team. As a CNA, you will provide high-quality patient care and support to individuals in need of hospice services. If you are passionate about delivering exceptional care and making a difference...


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

    Job SummaryUnder the general direction of the Executive Director, Corporate Controller, the Reimbursement Director is responsible for coordinating all CMS reporting requirements, including oversight of GME reporting functions. Additionally, this role involves the administration of the charge description master and revenue forecasting for both budget and...


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

    Job SummaryUnder the general direction of the Executive Director, Corporate Controller, this role is responsible for coordinating all CMS reporting requirements, including oversight of GME reporting functions. Additionally, the incumbent will administer the charge description master and revenue forecasting for both budget and month-end close. The ideal...

  • Reimbursement Director

    2 months ago


    Gainesville, United States Northeast Georgia Health System Full time

    Job Summary Under the general direction of the Executive Director, Corporate Controller, responsible for the coordination of all CMS reporting requirements including oversite of the GME reporting functions. In addition, responsible for the administration of the charge description master and revenue forecasting for both budget and month-end close. Will...

  • Reimbursement Director

    2 months ago


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

    Job Category:Accounting & Finance, Executive Leadership Work Shift/Schedule:8 Hr Evening - MorningNortheast Georgia Health System is rooted in a foundation of improving the health of our communities. About the Role:Job SummaryUnder the general direction of the Executive Director, Corporate Controller, responsible for the coordination of all CMS reporting...


  • Gainesville, United States Northeast Georgia Health System Full time

    Job SummaryUnder the general direction of the Executive Director, Corporate Controller, responsible for the coordination of all CMS reporting requirements including oversite of the GME reporting functions. In addition, responsible for the administration of the charge description master and revenue forecasting for both budget and month-end close. Will serve...


  • Gainesville, United States Northeast Georgia Health System Full time

    Job SummaryUnder the general direction of the Executive Director, Corporate Controller, responsible for the coordination of all CMS reporting requirements including oversite of the GME reporting functions. In addition, responsible for the administration of the charge description master and revenue forecasting for both budget and month-end close. Will serve...


  • Gainesville, Florida, United States HCA Florida North Florida Hospital Full time

    Director Respiratory Therapy Job DescriptionWe are seeking a highly skilled and experienced Director Respiratory Therapy to join our team at HCA Florida North Florida Hospital. As a key member of our healthcare team, you will be responsible for overseeing the respiratory therapy department and ensuring the delivery of high-quality patient care.Key...


  • Gainesville, Florida, United States HCA Florida North Florida Hospital Full time

    Director Respiratory Therapy Job DescriptionWe are seeking a highly skilled and experienced Director Respiratory Therapy to join our team at HCA Florida North Florida Hospital. As a key member of our healthcare team, you will be responsible for overseeing the respiratory therapy department and ensuring the delivery of high-quality patient care.Key...


  • Gainesville, Texas, United States Cantex Continuing Care Network Full time

    Job SummaryThe Executive Director, LNFA position is a critical role within the Cantex Continuing Care Network, responsible for directing the overall operation of the facility in accordance with applicable local, state, and federal regulations.Key ResponsibilitiesEnsure facility compliance with federal, state, and local regulations.Develop and implement...

  • Activity Director

    2 weeks ago


    Gainesville, Texas, United States Cantex Continuing Care Network Full time

    Job SummaryCantex Continuing Care Network is seeking a skilled Activity Director to join our team at the Renaissance Care Center in Gainesville, TX. As a key member of our staff, you will be responsible for creating and implementing engaging social and recreational programs for our patients/residents.Key ResponsibilitiesAssess patient/resident interests and...

  • Activity Director

    4 weeks ago


    Gainesville, Florida, United States Cantex Continuing Care Network Full time

    Job Summary:The Activity Director position at Cantex Continuing Care Network is responsible for creating engaging social and recreational programs for patients/residents. This role requires coordination, development, and maintenance of quality programs that provide mental and physical stimulation.Key Responsibilities:Assess patient/resident interests,...

  • Activity Director

    2 weeks ago


    Gainesville, Florida, United States Cantex Continuing Care Network Full time

    Job Summary:The Activity Director position at Cantex Continuing Care Network is responsible for providing opportunities for patients/residents to engage in meaningful social and diversified special interest programs based on their needs, interests, capabilities, and previous lifestyles.Key Responsibilities:Assess each patient/resident for interests, talents,...

  • Nurse Director

    4 days ago


    Gainesville, TX, United States Cantex Continuing Care Network Full time

    Job SummaryThe Director of Nursing Services is responsible for planning, organizing, and directing the overall operation of the Nursing Department at Cantex Continuing Care Network. This role ensures the quality of care is delivered consistently to the patient population, adhering to local, state, and federal guidelines and regulations.Key Responsibilities...


  • Gainesville, United States Cantex Continuing Care Network Full time

    Job DetailsJob LocationRenaissance Care Center - Gainesville, TXEducation LevelCertificationTravel PercentageNoneJob ShiftDayDescriptionDiversity, Equity, and Inclusion are at the heart of Cantex. We are committed to a culture that respects our differences and values the contributions of all people.Please visit cantexcc.com for more information on this...


  • Gainesville, United States Cantex Continuing Care Network Full time

    Job DetailsJob Location Renaissance Care Center - Gainesville, TX Education Level Certification Travel Percentage None Job Shift Day Description Diversity, Equity, and Inclusion are at the heart of Cantex. We are committed to a culture that respects our differences and values the contributions of all people. Please visit cantexcc.com for more information on...


  • Gainesville, United States Northeast Georgia Health System, Inc Full time

    Job Category:Executive Leadership, Revenue Cycle Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia Health System is rooted in a foundation of improving the health of our communities. About the Role:Job SummaryThis position reports to the Executive Director of Hospital Revenue Cycle Operations and is responsible for implementing, developing,...

  • Nursing Director

    4 days ago


    Gainesville, TX, United States Cantex Continuing Care Network Full time

    Job Summary: The Director of Nursing Services is responsible for planning, organizing, and directing the overall operation of the Nursing Department at Cantex Continuing Care Network. This role ensures the quality of care is delivered consistently to the patient population.Key Responsibilities:* Oversees the provision of appropriate medications, treatments,...

  • Clinical Director

    2 weeks ago


    Gainesville, Florida, United States Concierge Home Care Full time

    Job OverviewConcierge Home Care is seeking a highly skilled Clinical Manager to oversee home health services in Gainesville, FL.The ideal candidate will have a strong background in nursing and experience in skilled, geriatric home health care.Key ResponsibilitiesSupervise home health services to patients in place of residence by physician ordersEnsure...


  • Gainesville, United States HCA North Florida Division Full time

    Description Specialization:Hospice and Palliative MedicineJob Summary:HCA Florida North Florida Hospital in Gainesville, Florida, in conjunction with the University of Central Florida College of Medicine (UCF COM), is seeking an exceptional hospice and palliative care physician to join as their Program Director for their established program. Qualified...

  • Program Coordinator I

    2 weeks ago


    Gainesville, Florida, United States InsideHigherEd Full time

    Job SummaryWe are seeking a highly organized and detail-oriented Program Coordinator I to join our team in the Department of Surgery. The successful candidate will be responsible for maintaining records for past and present trainees, monitoring and documenting their progression towards graduation requirements, and preparing for regular meetings with program...