DIRECTOR REIMBURSEMENT ACCOUNTING

Job Summary Position Purpose:

The Director Reimbursement Accounting provides leadership and oversight of the monthly and annual reporting, reviewing, and analysis of net patient revenue and accounts receivable for both facility and professional revenues. This role is responsible for monthly financial close, reviews and analyses reported data, and coordination with EPIC reports. The Director supports the completion of the Medicare and other third-party cost reports, and the monthly accounting financial close, and is responsible for developing and creating the annual net patient revenue budget using data from the budgeting system and EPIC.

Key Job Activities:

-Coordinates related annual audits for internal and external sources.

-Coordinates third party audits and assist in long term planning of activities and strategies.

-Coordinate all components of the monthly revenue activity related to net patient revenue.

-Manages and coordinates preparation and responsiveness for corresponding compliance audits that occur, weather for inter or external audits, related to patient revenue.

-Coordinate the monthly computation of contractual allowances and bad debt for the net patient revenue reporting.

-Analyzes and applies the zero-based patient accounts reporting from EPIC to ensure contractual allowances are accurate and appropriate representation of accrued net patient revenue

-Works and consults with revenue cycle division regarding accounting and reimbursement needs, apply judgement and analytical techniques to evaluate appropriate distribution of revenues, contractual and bad debt allowances.

-Ensures net patient accounts receivable and due to third party reserves are calculated and recorded in accordance with models and other analysis.

-Reconciles and tracks Due to Third Party reimbursement balance sheet accounts.

-Ensures all data included in the cost reports is based on auditable, verifiable, and adequate documentation.

-Partners with external consultants to file and resolve cost report appeals.

-Coordinates reimbursement audits conducted by Medicare and other third-party auditors and prepares federal appeal position papers for outstanding issues that cannot be resolved.

-Provides complex financial modeling for completing the annual net patient revenue for the annual operating budget.

-Primary contact for all net patient accountings revenue and related areas.

-Manages different reimbursement vendors and ensures reporting requirements required by such vendors are completed timely and accurately.

-Constantly looks for revenue enhancements and cost efficiency opportunities.

-Communicate progress and setbacks in order for management to handle processes accordingly.

-Provide support and guidance to non-accounting staff in a manner that is understandable and actionable.

-Performs other duties as assigned.

Education and Work Experience:

• Bachelor’s degree in Accounting, Finance, or Business required.
• CPA and/or MBA preferred.
• 7+ years of hospital/healthcare finance and accounting experience.
• 5-7 years of progressively increasing management experience.
• Multiple site and multiple entity experience • Previous experience in a fast-paced, continually changing/growing environment.

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