Texas Health Huguley FWS
Director Reimbursement
Texas Health Huguley FWS, Altamonte Springs, Florida, United States, 32717
Job Description - Director Reimbursement (25029753)
Job Description
Director Reimbursement ( Job Number: 25029753 )
Description
All the benefits and perks you need for you and your family:
Benefits from Day One
Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Job Location
: AltamonteSprings, FL The role you will contribute: The Reimbursement Director directs the Reimbursement Department's financial analysis and reimbursement activities. These activities include preparation and filing the annual Medicare, Medicaid, and Champus/Tricare cost reports; preparation of reopening and appeal papers, audit preparation and other cost report settlement activity and related analysis for third party financial statement reporting for the Adventist Health System (AHS). This position collaborates with management in the reimbursement regulations and regulatory, operational, and financial impacts of proposed operational decisions; and serves as subject matter resource for Medicare and Medicaid reimbursement matters. The Director is responsible for creating a work environment that supports a strong team, and challenges team members to continually strive for improvements in work processes. The Director actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. The value you will bring to the team: Serve as AHS’ subject matter resource for Medicare and Medicaid reimbursement matters Maintain a strong working knowledge of current laws and regulations of the Federal Medicare and State Medicaid programs, including changes affecting hospital reimbursement of Medicare bad debt, graduate medical education, disproportionate share hospital adjustment, and uncompensated care payments Communicate technical positions/arguments effectively to Medicare, Medicaid and other State or Federal agencies’ auditors to support positions taken on the hospital cost report, or other required reporting Review the Medicare and Medicaid Uniform Contractual Worksheet-Third Party Settlement (UCW-TPS) templates of each AHS hospital according to standardized policies and procedures to properly reflect the financial reporting of third party balances of AHS Prepare year end estimated Medicare and Medicaid third party financial settlement to be audited by AHS’ external financial auditor for inclusion in the audited financial statements Prepare annual Medicare Inpatient and Outpatient net revenue schedules used to prepare hospital annual operating net revenue budget Maintain awareness of organizational administrative and operational changes that could impact the hospital’s Medicare and/or Medicaid reimbursement Direct financial analysis and modeling activities to determine the financial and reimbursement implication of proposed business transactions and changes in regulatory requirements Complete special projects assigned by Corporate Leadership within the time frame requested Daily supervision of department staff Foster an environment that promotes strong team values and cooperation Recruit and retain high performance employees Hire, dismiss, develop and evaluate the individual members of the department staff Qualifications The expertise and experiences you’ll need to succeed: Bachelor's Required 10+ Work Experience Required Strong and proven leadership skills In depth knowledge of Medicare and state Medicaid program reimbursement laws and regulations Ability to research and interpret Medicare and Medicaid laws and regulations Proficient in use of regulatory cost reporting software Possess an understanding of financial accounting and auditing principles and their application to healthcare Strong computer software skills including Microsoft Office applications Ability to learn new technology applications used by Adventist Health System Strong analytical reasoning, critical thinking, judgment and problem solving skills in order to independently assess, interpret and address complex issues in a continually changing environment Effective written and verbal communication skills Excellent interpersonal skills Well organized and detail-oriented Proficient using Health Financial Systems (HFS) cost reporting software Preferred Qualifications: Master's Preferred Certified Public Accountant (CPA) Preferred
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: AltamonteSprings, FL The role you will contribute: The Reimbursement Director directs the Reimbursement Department's financial analysis and reimbursement activities. These activities include preparation and filing the annual Medicare, Medicaid, and Champus/Tricare cost reports; preparation of reopening and appeal papers, audit preparation and other cost report settlement activity and related analysis for third party financial statement reporting for the Adventist Health System (AHS). This position collaborates with management in the reimbursement regulations and regulatory, operational, and financial impacts of proposed operational decisions; and serves as subject matter resource for Medicare and Medicaid reimbursement matters. The Director is responsible for creating a work environment that supports a strong team, and challenges team members to continually strive for improvements in work processes. The Director actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. The value you will bring to the team: Serve as AHS’ subject matter resource for Medicare and Medicaid reimbursement matters Maintain a strong working knowledge of current laws and regulations of the Federal Medicare and State Medicaid programs, including changes affecting hospital reimbursement of Medicare bad debt, graduate medical education, disproportionate share hospital adjustment, and uncompensated care payments Communicate technical positions/arguments effectively to Medicare, Medicaid and other State or Federal agencies’ auditors to support positions taken on the hospital cost report, or other required reporting Review the Medicare and Medicaid Uniform Contractual Worksheet-Third Party Settlement (UCW-TPS) templates of each AHS hospital according to standardized policies and procedures to properly reflect the financial reporting of third party balances of AHS Prepare year end estimated Medicare and Medicaid third party financial settlement to be audited by AHS’ external financial auditor for inclusion in the audited financial statements Prepare annual Medicare Inpatient and Outpatient net revenue schedules used to prepare hospital annual operating net revenue budget Maintain awareness of organizational administrative and operational changes that could impact the hospital’s Medicare and/or Medicaid reimbursement Direct financial analysis and modeling activities to determine the financial and reimbursement implication of proposed business transactions and changes in regulatory requirements Complete special projects assigned by Corporate Leadership within the time frame requested Daily supervision of department staff Foster an environment that promotes strong team values and cooperation Recruit and retain high performance employees Hire, dismiss, develop and evaluate the individual members of the department staff Qualifications The expertise and experiences you’ll need to succeed: Bachelor's Required 10+ Work Experience Required Strong and proven leadership skills In depth knowledge of Medicare and state Medicaid program reimbursement laws and regulations Ability to research and interpret Medicare and Medicaid laws and regulations Proficient in use of regulatory cost reporting software Possess an understanding of financial accounting and auditing principles and their application to healthcare Strong computer software skills including Microsoft Office applications Ability to learn new technology applications used by Adventist Health System Strong analytical reasoning, critical thinking, judgment and problem solving skills in order to independently assess, interpret and address complex issues in a continually changing environment Effective written and verbal communication skills Excellent interpersonal skills Well organized and detail-oriented Proficient using Health Financial Systems (HFS) cost reporting software Preferred Qualifications: Master's Preferred Certified Public Accountant (CPA) Preferred
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