Reimbursement Strategy Director

1 week ago


Gainesville, Florida, United States Northeast Georgia Health System Full time
About the Role

We are seeking a highly skilled Reimbursement Strategy Director to join our team at Northeast Georgia Health System.

Job Summary

This is a dynamic role that requires a strategic thinker with expertise in reimbursement analysis and CMS cost reporting. The successful candidate will oversee all aspects of charge description master functions, revenue forecasting, and regulatory compliance. They will also be responsible for leading our organization's efforts in revenue cycle process improvement and ensuring accurate billing practices.

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 the 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.
  • Overses 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.
  • 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.
  • Remain current with updated coding and billing regulations.


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