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AdventHealth

Director Reimbursement

AdventHealth, Florida, New York, United States

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All the benefits and perks you need for you and your family: Benefits from Day One

Career Development

Whole Person Wellbeing Resources

Mental Health Resources and Support

Our promise to you: Joining AdventHealth is about being part of something bigger. Its 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. Shift

: Monday- Friday Fulltime Job Location

: Altamonte Springs, 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 hospitals 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

Prepare annual department budget

Develop annual department goals

Hire, dismiss, develop and evaluate the individual members of the department staff

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

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location. Category:

Accounting/Finance Organization:

AdventHealth Corporate Schedule:

Full-time Shift:

1 - Day Req ID:

25029753 We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.

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