Reimbursement Manager - Reimbursement and Revenue Integrity - FT - Days - MHS

The Reimbursement Manager completes tasks as assigned to assist Directors and the Vice President of Reimbursement & Revenue Integrity with: Medicare and Champus cost reporting and audits, interim rate and settlement calculations, Medicaid waiver reports, maintenance of net revenue preparation and analysis, and various other projects.

Responsibilities

Complete tasks as assigned to assist Directors and the Vice President of Reimbursement & Revenue Integrity with Medicare and Champus cost reporting and audits, interim rate and settlement calculations, Medicaid waiver reports, maintenance of net revenue preparation and analysis, and various other projects; Stay current with the Medicare/Medicaid and other third party payor regulations and determining the impact to the System; Monitor and research state and federal requirements to ensure adequate understanding of compliance issues and opportunities and to ensure timely communication to all affected parties; Participate in the preparation, input, and analysis of the annual Medicare, Medicaid and Champus cost reports; Provide analytical support for the timely and accurate preparation of the cost reports, including information for the preparation of the cost reports, audit schedules, and account reconciliations; Monitor and maintain various cost report statistics such as time studies, meal count and square footage; Coordinate outside audit responses and efforts of outside consultants responsible for Medicare Disproportionate Share Hospital (DSH) payments, Medicare Bad Debt, Medicare Appeals, and review of Medicare Indirect Medical Education (IME) and Graduate Medical Education (GME) payments; Develop responses to Medicare reviews including Wage Index and Occupational Mix Survey; Compile and analyze Medicaid DSH and Low Income Pool (LIP) supporting schedules and final reports; Draft related audit responses; Develop strategic plans for future payment enhancements; Prepare monthly close and annual financial statement documents related to net revenue and supports annual accounting audit of same; Function as primary backup to the Directors in the monthly close process; Maintains roll forward schedule of third-party settlement balances and their application as part of the monthly close process and annual financial audit; Review and approval of outside consultant invoices for Medicare Transfer reimbursement improvements

Requirements

Bachelors; Five (5) years of progressively responsible experience in hospital reimbursement operations, audit or consulting including projects specifically related to Medicare and Medicaid reimbursement; Thorough knowledge of Medicare, Medicaid and Champus rules and regulations and third party audit techniques; Proficient in Microsoft Office products and Cost Reporting Software; Critical thinking skills; Effective communication; Decisive judgment; Ability to build and foster positive relationships; Ability to lead others and take appropriate action; Accountability; Accounting - Cost Reports; Accuracy; Customer Service; Financial Analysis; Healthcare Regulatory Environment; Regulatory Compliance; Responding to Change; Standards of Behavior; Workload Management