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Director of Reimbursement

Company: Northeast Georgia Health System, Inc.
Location: Gainesville
Posted on: November 17, 2021

Job Description:

Director of ReimbursementNortheast Georgia Health System. 3.7 - Gainesville, GA 30501. Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.. Director of Reimbursement. *Sign-On Bonus and Relocation assistance offered for qualified candidates*. Job Summary:. Under the general direction of the Executive Director/Corporate Controller responsible for the coordination of all CMS reporting requirements including oversite of the GME reporting functions. In addition, responsible for the administration of the charge description master and revenue forecasting for both budget and month-end close. Will serve as the organization expert on CMS regulatory changes and will make recommendations to senior management related to proposed changes. Takes the lead for the organization's Accounts Receivable review and analysis.. Minimum Job Qualifications:. Bachelor's Degree in Business Administration, Finance, Accounting or other related area.. Minimum five to seven years relevant work experience in healthcare financial management including revenue modeling and CMS cost reporting activities.. Preferred Education/Skills:. Master's degree or CPA strongly preferred.. Operational experience as a Director in a health system is preferred.. Job Specific and Unique Knowledge, Skills and Abilities:. Ability to research complex coding, reimbursement and regulatory requirements.. Knowledge of clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology.. Must have a good understanding of the CDM and its relationship to related areas such as the General Ledger, Cost Accounting, Inventory, Productivity, Cost Reporting and Budget.. Extensive knowledge of CPT/HCPCS, UB-92 Revenue Coding, modifiers, billing regulations, DRGs and APCs.. Understanding of Graduate Medical Education and health care financing issues.. Ability to understand and analyze payor contracts/regulations and model net revenue impacts based on reimbursement and coding guidelines.. Essential Tasks and Responsibilities:. Supervision and coordination of Chargemaster management functions in researching coding and billing guidelines, researching insurance contracts, and updating hospital Chargemaster.. Works with the revenue producing departments to ensure the ongoing coordinated consistency of the Chargemaster, including accurate descriptions, coding, additions, deletions, pricing, charging methodology and any other changes.. Maintain a working knowledge of revenue cycle process to aid in the implementation of regulatory standards that assist the health system in cash collection while accurately complying with billing guidelines.. Maintain a working knowledge of revenue cycle process to aid in the implementation of regulatory standards that assist the health system in cash collection while accurately complying with billing guidelines.. Performs analysis, identifies trends, validation of compliance as related to fiscal activities generating additional revenue, reducing bad debt expense and charity write-offs and overall expense reduction.. Prepares, monitors, and files Medicare and Medicaid Cost Reports assuring maximization of reimbursement from third-party payors.. Responds to surveys affecting Medicare and Medicaid rate revisions, interim payments, and hospital-based physician arrangements.. Coordinates financial audits conducted by CMS, DCH, and other governmental intermediaries on prior year's cost reports and surveys.. Provides management for Indigent Care Trust Fund processes and reporting.. Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.. NGHS: Opportunities start here.. Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.. Thousands of employers search for candidates on Indeed. Yes. -. I plan to apply. -. No, I don't intend to apply

Keywords: Northeast Georgia Health System, Inc., Gainesville , Director of Reimbursement, Accounting, Auditing , Gainesville, Florida

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