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Manager Of Reimbursement

Owensboro Medical Health System

Location: Owensboro, KY 42302
Type: Full-Time, Non-Remote
Posted on: October 21, 2020
This job is no longer available from the source.
3 DAYS AGO
Full Time
Job Summary Responsible for coordinating the preparation and settlements of all cost reports and other reports to outside entities. Responsible for reimbursement functions and reporting at all entities at Owensboro Health. Job Responsibilities Oversees all reimbursement functions. Coordinates the preparation and documentation of Medicare and Medicaid cost reports and related filings. Maintains adequate schedules and analysis to support settlement accounts. Prepares appeals and re-openings of Medicare and Medicaid cost reports, and coordinates the accurate settlements of all issues. Coordinates support for audits of cost reports and other third party filings. Prepares pro forma cost reports or other analysis to evaluate proposed regulatory changes as needed. Prepares other reports, such as the IRIS report, the Blue Cross report, Medicaid DSH filings, and ad hoc external reports. Supports the development of hospital and Owensboro Health budgets and the calculations of revenue deductions, contractual allowances, bad debt and other reserves and settlement accounts as requested. Maintains sufficient knowledge of System operations and Federal and State regulations to ensure compliance with all laws. Coordinates revenue maximization and initiatives and lead Finance input into compliance initiatives throughout Owensboro Health with respect to governmental programs. Represents Owensboro Health in consultations with the Kentucky Medicaid program around reimbursement programs, including DSH. Coordinates with CFOs of other major Kentucky health systems, the Kentucky Hospital Association and outside counsel. Contributes to development and maintenance of all department and hospital system enhancements as required, including revenue modeling. Ensures adherence to all third party reporting requirements. Maintains necessary technical application skills. Reviews, analyzes and makes recommendations on proposed legislation. Authors comment letters on such legislation on behalf of Owensboro Health. Supports, through analysis and reporting, the Owensboro Health seat on the Medicaid Technical Advisory Committee as directed by the Vice President of Finance. Completes all provider based applications, Medicare 855s, financial analyses and other projects under the direction of the Vice President of Finance. Works collaboratively with the Owensboro Health Managed Care staff to ensure contract compliance and successful implementation of any Medicaid and Medicare managed care agreements. Manages staff relations including performance management, staff satisfaction and conflict management.Performs and oversees scheduling, recruitment, and payroll. Organizational Responsibilities Adheres to all organizational policies and procedures. Executes all tasks and behaves in a manner consistent with a culture of compliance, safety and a high reliability organization; behavior supports the organization#s core commitments of Integrity, Service, Respect, Teamwork, Excellence, and Innovation. Leadership Responsibilities Creates and maintains a work environment that is aligned with the organization#s goals and strategies, demonstrating a unified voice and consistent message from leadership; actively supports all organizational policies and procedures in communications and interactions with staff and peers. Communicates and implements change in a positive and effective manner. Education Bachelor#s degree in Accounting, Business Administration, Finance, or related field required. Master#s degree preferred. A combination of education, training and experience may be considered in lieu of degree. Licensure/Certification/Registration None required. Work Experience 4 years progressive experience in a related field required. Skills and Attributes Requires critical thinking skills and decisive judgment. Works under minimal supervision. Must be able to work in a stressful environment and take appropriate action. Strong PC skills in applications such as Excel, Access, Word and PowerPoint are important, and experience with cost report software is essential. Strong communication skills and demonstrated attention to details and accuracy are required. FLSA Classification Exempt Disclaimer This description is intended to describe the general nature and level of work performed by employees assigned to this position. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees. Specific duties and responsibilities consistent with the general nature and level of work described may vary by department and additional related duties may be assigned as needed. Some duties listed may not apply to all areas. Additional Position Related Details Populations Served Training is provided relevant to the population served, based on scope of care of the service assignment. Physical Requirements Activity and Frequency: Bending/Stooping - Never Climbing - Never Keyboard Data Entry - Frequently Kneeling - Never Lifting/Moving Patients - Never Lifting/Carrying (Non-Patient) - 0-25 lbs - Never Lifting/Carrying (Non-Patient) - 25-75 lbs - Never Lifting/Carrying (Non-Patient) - over 75 lbs - Never Pushing/Pulling - 0-25 lbs - Never Pushing/Pulling - 25-75 lbs - Never Pushing/Pulling - over 75 lbs - Never Reaching - Never Repetitive Foot/Leg Movements - Never Repetitive Hand/Arm Movements - Frequently Running - Never Sitting - Frequently Squatting - Never Standing - Frequently Walking - Frequently Audible Speech - Frequently Hearing Acuity - Frequently Smelling Acuity - Never Taste Discrimination - Never Vision: Depth Perception - Frequently Vision: Distinguish Color - Frequently Vision: Seeing - Far - Frequently Vision: Seeing - Near - Frequently Exposures Owensboro Health is committed to providing a safe working environment including training and access to person protective equipment necessary to this position. While performing duties of this position, occupational exposure to bloodborne pathogens is present for all employees.* Job Summary* Responsible for coordinating the preparation and settlements of all cost reports and other reports to outside entities. Responsible for reimbursement functions and reporting at all entities at Owensboro Health.* Job Responsibilities* Oversees all reimbursement functions.* Coordinates the preparation and documentation of Medicare and Medicaid cost reports and related filings.* Maintains adequate schedules and analysis to support settlement accounts.* Prepares appeals and re-openings of Medicare and Medicaid cost reports, and coordinates the accurate settlements of all issues.* Coordinates support for audits of cost reports and other third party filings.* Prepares pro forma cost reports or other analysis to evaluate proposed regulatory changes as needed.* Prepares other reports, such as the IRIS report, the Blue Cross report, Medicaid DSH filings, and ad hoc external reports.* Supports the development of hospital and Owensboro Health budgets and the calculations of revenue deductions, contractual allowances, bad debt and other reserves and settlement accounts as requested.* Maintains sufficient knowledge of System operations and Federal and State regulations to ensure compliance with all laws.* Coordinates revenue maximization and initiatives and lead Finance input into compliance initiatives throughout Owensboro Health with respect to governmental programs.* Represents Owensboro Health in consultations with the Kentucky Medicaid program around reimbursement programs, including DSH. Coordinates with CFOs of other major Kentucky health systems, the Kentucky Hospital Association and outside counsel.* Contributes to development and maintenance of all department and hospital system enhancements as required, including revenue modeling.* Ensures adherence to all third party reporting requirements.* Maintains necessary technical application skills.* Reviews, analyzes and makes recommendations on proposed legislation. Authors comment letters on such legislation on behalf of Owensboro Health.* Supports, through analysis and reporting, the Owensboro Health seat on the Medicaid Technical Advisory Committee as directed by the Vice President of Finance.* Completes all provider based applications, Medicare 855s, financial analyses and other projects under the direction of the Vice President of Finance.* Works collaboratively with the Owensboro Health Managed Care staff to ensure contract compliance and successful implementation of any Medicaid and Medicare managed care agreements.* Manages staff relations including performance management, staff satisfaction and conflict management.Performs and oversees scheduling, recruitment, and payroll.* Organizational Responsibilities* Adheres to all organizational policies and procedures. Executes all tasks and behaves in a manner consistent with a culture of compliance, safety and a high reliability organization; behavior supports the organization's core commitments of Integrity, Service, Respect, Teamwork, Excellence, and Innovation.* Leadership Responsibilities* Creates and maintains a work environment that is aligned with the organization's goals and strategies, demonstrating a unified voice and consistent message from leadership; actively supports all organizational policies and procedures in communications and interactions with staff and peers. Communicates and implements change in a positive and effective manner.* Education* Bachelor's degree in Accounting, Business Administration, Finance, or related field required. Master's degree preferred. A combination of education, training and experience may be considered in lieu of degree.* Licensure/Certification/Registration* None required.* Work Experience* 4 years progressive experience in a related field required.* Skills and Attributes* Requires critical thinking skills and decisive judgment. Works under minimal supervision. Must be able to work in a stressful environment and take appropriate action.* Strong PC skills in applications such as Excel, Access, Word and PowerPoint are important, and experience with cost report software is essential.* Strong communication skills and demonstrated attention to details and accuracy are required.* FLSA Classification* Exempt* Disclaimer* This description is intended to describe the general nature and level of work performed by employees assigned to this position. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees. Specific duties and responsibilities consistent with the general nature and level of work described may vary by department and additional related duties may be assigned as needed. Some duties listed may not apply to all areas.* Additional Position Related Details* Populations Served* Training is provided relevant to the population served, based on scope of care of the service assignment.* Physical Requirements* Activity and Frequency:* Bending/Stooping - Never* Climbing - Never* Keyboard Data Entry - Frequently* Kneeling - Never* Lifting/Moving Patients - Never* Lifting/Carrying (Non-Patient) - 0-25 lbs - Never* Lifting/Carrying (Non-Patient) - 25-75 lbs - Never* Lifting/Carrying (Non-Patient) - over 75 lbs - Never* Pushing/Pulling - 0-25 lbs - Never* Pushing/Pulling - 25-75 lbs - Never* Pushing/Pulling - over 75 lbs - Never* Reaching - Never* Repetitive Foot/Leg Movements - Never* Repetitive Hand/Arm Movements - Frequently* Running - Never* Sitting - Frequently* Squatting - Never* Standing - Frequently* Walking - Frequently* Audible Speech - Frequently* Hearing Acuity - Frequently* Smelling Acuity - Never* Taste Discrimination - Never* Vision: Depth Perception - Frequently* Vision: Distinguish Color - Frequently* Vision: Seeing - Far - Frequently* Vision: Seeing - Near - Frequently* Exposures* Owensboro Health is committed to providing a safe working environment including training and access to person protective equipment necessary to this position. While performing duties of this position, occupational exposure to bloodborne pathogens is present for all employees.
Location/Region: Owensboro, KY (42302)