Director, Corporate Reimbursement
1 week ago
The Director will serve as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment strategies across all RWJBarnabas Health hospitals. This includes planning, preparing and reviewing of the annual Medicare/Medicaid cost reports filings. In partnership with the Senior Vice President of Office of Reimbursement, the Director will manage the completion of DSH, Medicare Bad Debts, Wage Index, and Geographic Reclassification projects. In addition, the Director will closely assess, track, and monitor's participation in state level supplemental payments programs and will be asked to assist with regulatory research. The Director will also work closely with finance department personnel at system facilities and will oversee the accurate determination of third party receivables/payables, ensuring revenue and receivables reporting complies with GAAP. The Director will have advanced level of knowledge of government payment regulation, third party revenue accounting practices, and have excellent communication/staff management skills. Furthermore, promotes a positive atmosphere and maintains a high degree of customer service orientation to include proactive interaction with staff and managers.
Qualifications:
Required:
- BS/BA in Accounting, Finance, or Health Administration required.
- Minimum of 10 years of experience interpreting Medicare and Medicaid payment regulations, ensuring optimization of revenue and completing Medicare and Medicaid cost reports.
- Expert level of knowledge of Medicare and Medicaid regulation and payment rules is essential.
- The ability to interpret Medicare and Medicaid payment regulations and develop and implement processes ensuring hospitals are reimbursed for all programs and services is required.
- Educated on and follows Generally Accepted Accounting Principles (GAAP);
- Proactively prioritizes needs and effectively manages resources;
- Delegates and trains appropriately to ensure required deadlines are met; Communication - communicates clearly and concisely;
- Guides individuals and groups toward desired outcomes with minimal supervision, sets high performance standards and delivers high quality services;
- Demonstrates appropriate decision-making skills and escalates issues to supervisor as appropriate
- Establish and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations;
- Coordinates with leadership and deploys and directs resources appropriately (e.g. Cost Report preparation, Wage Index, etc.) as directed;
- Demonstrates proficiency in Microsoft Office applications (i.e. Excel, Word) and others as required
- HFMA Certification
- Prepares Medicare and Medicaid cost reports and supporting forms/schedules as required
- Responsible for the completion and review of the annual New Jersey Acute Care Hospital (SHARE) cost reports
- Monitor and validate State and federal issued reimbursement rates
- Investigates and responds to audit reviews/questions/adjustments
- Regularly monitor and evaluate changes in reimbursement regulations and policies to optimize reimbursement opportunities
- Monitor Medicare and Medicaid appeal and cost report reopening issues.
- Completed Medicare 855As (and Medicaid) when applicable - such as Change of Ownership (CHOW) and Change of Information applications
- Completed the annual Medicaid DSH Surveys.
- Manage and optimize the data collection and reporting process for the Medicare, Medicaid and NJ SHARE cost reports (Physician Time Studies, Contracted Labor, A-6 Reclasses, and B-1 Statistics)
- Maintains working knowledge of various Medicaid state regulations and Medicare federal regulations.
- Assists in orientation, training and development of new Financial Analysts as needed.
- Supervises Financial and Senior Financial Analyst(s) in completion of certain projects when assigned by senior management.
- Assists in Reimbursement Department projects not listed above.
- Assists in special projects as needed.
- Other work duties as assigned.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time, with or without notice.
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