Manager Enterprise Reimbursement - Net Revenue PB

Overview

This position ensures that all hospitals are compliant with state and federal regulatory reporting requirements related to reimbursement. The role requires extensive knowledge of third-party reimbursement regulations and includes responsibilities for managing net revenue, developing budgets, conducting reserve analysis, and identifying and implementing revenue enhancement opportunities.

Responsibilities

• Ensure hospitals comply with all state and federal regulations related to reimbursement.
• Manage the preparation and analytical review of external Medicare Cost Reports, WV HCA filings, and other state or federal reimbursement filings for all hospitals.
• Review and analyze state and federal reimbursement regulations to ensure compliance and present the financial impact of regulatory changes.
• Communicate with external auditors, third-party payors, and WV HCA staff regarding financial matters.
• Coordinate development of the net revenue budget.
• Establish and maintain a process for ongoing monitoring of gross and net revenue, including analysis of reserves for contractuals, bad debt, and charity.
• Coordinate with patient financial services and accounting to process changes in third-party payment requirements and assess impacts on financial reporting and financial statements.
• Ensure financial terms of managed care contracts are thoroughly and accurately analyzed and monitored.
• Ensure long-range financial planning includes accurate and up-to-date reimbursement assumptions.
• Coordinate projects related to revenue enhancement opportunities.
• Work with legal counsel and the fiscal intermediary to identify and resolve outstanding Medicare appeal issues.
• Develop and maintain ongoing staff development and orientation programs for reimbursement staff.
• Monitor and document staff performance and use appropriate reward and disciplinary measures as needed.
• Provide leadership and direction to professional staff, maintain professional relationships across staff, respond to staff concerns professionally and timely, and maintain appropriate interdepartmental communication.

Minimum Qualifications

• Education: Bachelor’s Degree in Business with a major in Accounting or Finance.
• Experience: Five (5) years of experience in healthcare finance or accounting.

Preferred Qualifications

• Education/Certification: MBA or CPA.

Skills and Abilities

• Effective verbal and written communication skills and strong interpersonal skills.
• Extensive knowledge of personal computers; Excel software is desirable.

Compensation & Benefits

• Not specified.

Location

• United States of America

Schedule

• Scheduled Weekly Hours: 40

Employment Status

• Exempt/Non-Exempt: Exempt