Manager, Reimbursement

The Reimbursement Manager is responsible for the recording of Patient Net Revenue and related reserves of a multi-hospital system comprised of acute care, Children’s, and teaching facilities. This position must remain abreast of federal and state regulations concerning the Medicare, Medicaid and CHAMPUS programs, industry trends in Managed Care contracting, the specific payment arrangements applicable to the organization, as well as Generally Accepted Accounting Procedures to ensure the production of accurate financial statements. This position has an integral role in Net Revenue Budget preparation for the system. Must be able to interact with internal stakeholders (i.e. Hospital presidents and vice-presidents, associate CFO, CFO, Business Office personnel) as well as external stakeholders (i.e. consultants, financial auditors, bond holders, and Medicare and Medicaid Auditors). Must have a current knowledge of Medicare, Medicaid and CHAMPUS Cost Report regulations.

Key Accountabilities:

• This position takes a leadership role in the monthly and year-end closing process. Ensures accurate recording of third party contractual and bad debt allowances. Must be able to investigate variances in hospital net revenue and provide explanations to senior leadership.
• This position is responsible for preparing/maintaining documentation related to net revenue, contractual allowance accruals, and contingent liabilities for interim and year-end financial audits. Must be able to directly communicate and interact with external auditors on a variety of complex issues related to the corporation’s financial statements.
• This position has a leadership role in preparation of the corporate budget. Must be able to develop models, incorporating changes in regulations and payment arrangements that predict net revenue. The results of these models must be communicated to hospital leadership, Vice-President of Budgeting, as well as system senior leadership.
• Must be able to plan, organize, and complete complex analyses related to the corporation’s revenue (gross and net), contractual allowances, and bad debts. These efforts must incorporate any regulation changes, either proposed or final. The results of these efforts must be communicated to appropriate parties for incorporation into the system’s strategic plan.
• This position serves as a resource for Senior Leadership, Hospital Presidents and Vice-Presidents, Internal Audit and Compliance, and the CBO on issues related to reimbursement, accounting, provider tax, and system maintenance, as well as cost report preparation, filing, and settlement.

Required:

• Three years as a reimbursement or financial auditor

Desired:

• Three years calculating contractual allowances, payment modeling, reserving for contingent liabilities, and allowance for bad debt.
• Bachelor Degree