Emory Healthcare/Emory University
Government Reimbursement & Cost, Manager
Emory Healthcare/Emory University, Atlanta, Georgia, United States, 30383
Overview
Be inspired
.
Be rewarded. Belong. At Emory Healthcare.
At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoingmentorshipand leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:
Comprehensive health benefits that start day 1
Student Loan Repayment Assistance & Reimbursement Programs
Family-focused benefits
Wellness incentives
Ongoing mentorship,
development,
and leadership programs
And more
Description
Overview:
This position reports to the Director, Reimbursements and Net Patient Service Revenue (NPSR), and oversees analysis and reporting for Governmental Reimbursements for Emory Healthcare.
The Manager of Government Reimbursements is responsible for overseeing the financial reporting and analysis related to governmental reimbursements both federal and state, including cost reporting and audits.
This role involves ensuring accurate and timely revenue recognition and calculating the estimated reimbursements for Emory Healthcare.
The manager will work closely with hospital operations, clinical departments, and the finance team to support the financial reporting associated with the governmental reimbursements and required cost reporting compliance.
Responsible for preparing cost reports, monitoring compliance with CMS regulations, attestations, and preparing to report on all supplemental Federal and State reimbursement matters
Coordinates Medicare and Medicaid audits and assists with preparation of all supporting work papers and documentation across Emory Healthcare
Conducts detailed financial analyses to monitor revenue performance, identify trends, and develop insights to improve governmental reimbursements
Analyzes Medicare Administrative Contractor (MAC) correspondence and interim rate setting to ensure accurate reimbursement and compliance with regulations
Assists with monitoring changes in Federal and State regulations regarding hospital and physician reimbursement requirements, with priority focus on billing changes impacting physician and hospital chargemasters
Assist with Provider based attestations, and all Federal and State reporting associated with them
Monitors changes in Federal and State regulations affecting the healthcare industry and assists with preparation of pro-forma analysis as it relates to third-party reimbursement
Reviews and assists with preparation of the annual State of Georgia, DCH Reports, including DSH, GME, Hospital Financial Survey (HFS) and Indigent Care Trust Fund Survey (ICTF), etc.
Manages graduate medical education reporting and helps to provide organizational guidance to maximize reimbursements
Assists with preparation and review of annual hospital UPL and physician LIP reporting and other regulatory/contractually obligated reports
Prepares research, analyzes, and communicates reimbursement matters
Reviews and assists with strategic pricing analysis in association with the annual budget for charge master pricing and net revenues.
Develops year-end audit documentation; reviews and oversees detailed schedules and analysis to support financial statements. Works with external and internal auditors to interpret schedules and resolve discrepancies
Develops control procedures and assists in the development of new procedures to improve internal control measures
Prepares, develops, and monitors the budget and compliance with fiscal constraints related to governmental reimbursements for actual, budget and prior period financial information
Develops and reviews information and analysis for long-range financial and cash flow forecasting
Reviews and analyzes data trends in governmental reimbursements, works with vendors to develop analysis and support on-going and future reimbursements
Enhances and improves analysis to determine the impact of payer mix and changes to operations on governmental reimbursements
Develops recommendations to management
Identifies and reviews analysis involving new business initiatives and models governmental reimbursement impacts
Creates recommendations on policy issues to maintain compliance with regulations and guidelines
Enhances and is proactive in implementing procedures consistent with established policies
Supervises and analyzes current policies and procedures and assesses effectiveness
Oversees and manages special projects
Oversees the preparation of special impact studies and other financial surveys and questionnaires
Ensures professional development and attends educational in-services as appropriate.
Participates in professional activities and organizations to maintain knowledge of current trends, practices, and developments
Reviews, prepares and analyzes statistical reports, financial statements, and supporting schedules for management
Identifies, develops, and implements methods for improving reporting efficiency.
Identifies requirements and develops reports required by state and federal agencies and ensures compliance.
Provides guidance and direction to professional staff
Performs related responsibilities as required
Minimum Qualifications:
6 years related experience required with an MBA or CPA preferred.
Experience in preparation of Medicare and Medicaid cost reports required.
Experience with complex academic healthcare and transplants preferred.
Strong knowledge of Medicare and Medicaid reimbursement regulations.
Excellent analytical and problem-solving skills.
Proven leadership and team management abilities.
Preferred technical qualifications:
Knowledge and experience with Epic, Stratajazz, PeopleSoft, SQL, Power BI, EPSI and Kodiak (RCA).
Education:
A bachelor's degree in accounting, finance, data or business analytics or information systems related field.
Additional Details
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at careers@emoryhealthcare.org . Please note that one week's advance notice is preferred.
Connect With Us!
Connect with us for general consideration!
Division
Emory Healthcare Inc.
Campus Location
Atlanta, GA, 30345
Campus Location
US-GA-Atlanta
Department
EHI Hospitals Finance
Job Type
Regular Full-Time
Job Number
154302
Job Category
Business Operations
Schedule
8a-4:30p
Standard Hours
40 Hours
Hourly Minimum
USD $55.37/Hr.
Hourly Midpoint
USD $76.14/Hr.
Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.
Be inspired
.
Be rewarded. Belong. At Emory Healthcare.
At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoingmentorshipand leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:
Comprehensive health benefits that start day 1
Student Loan Repayment Assistance & Reimbursement Programs
Family-focused benefits
Wellness incentives
Ongoing mentorship,
development,
and leadership programs
And more
Description
Overview:
This position reports to the Director, Reimbursements and Net Patient Service Revenue (NPSR), and oversees analysis and reporting for Governmental Reimbursements for Emory Healthcare.
The Manager of Government Reimbursements is responsible for overseeing the financial reporting and analysis related to governmental reimbursements both federal and state, including cost reporting and audits.
This role involves ensuring accurate and timely revenue recognition and calculating the estimated reimbursements for Emory Healthcare.
The manager will work closely with hospital operations, clinical departments, and the finance team to support the financial reporting associated with the governmental reimbursements and required cost reporting compliance.
Responsible for preparing cost reports, monitoring compliance with CMS regulations, attestations, and preparing to report on all supplemental Federal and State reimbursement matters
Coordinates Medicare and Medicaid audits and assists with preparation of all supporting work papers and documentation across Emory Healthcare
Conducts detailed financial analyses to monitor revenue performance, identify trends, and develop insights to improve governmental reimbursements
Analyzes Medicare Administrative Contractor (MAC) correspondence and interim rate setting to ensure accurate reimbursement and compliance with regulations
Assists with monitoring changes in Federal and State regulations regarding hospital and physician reimbursement requirements, with priority focus on billing changes impacting physician and hospital chargemasters
Assist with Provider based attestations, and all Federal and State reporting associated with them
Monitors changes in Federal and State regulations affecting the healthcare industry and assists with preparation of pro-forma analysis as it relates to third-party reimbursement
Reviews and assists with preparation of the annual State of Georgia, DCH Reports, including DSH, GME, Hospital Financial Survey (HFS) and Indigent Care Trust Fund Survey (ICTF), etc.
Manages graduate medical education reporting and helps to provide organizational guidance to maximize reimbursements
Assists with preparation and review of annual hospital UPL and physician LIP reporting and other regulatory/contractually obligated reports
Prepares research, analyzes, and communicates reimbursement matters
Reviews and assists with strategic pricing analysis in association with the annual budget for charge master pricing and net revenues.
Develops year-end audit documentation; reviews and oversees detailed schedules and analysis to support financial statements. Works with external and internal auditors to interpret schedules and resolve discrepancies
Develops control procedures and assists in the development of new procedures to improve internal control measures
Prepares, develops, and monitors the budget and compliance with fiscal constraints related to governmental reimbursements for actual, budget and prior period financial information
Develops and reviews information and analysis for long-range financial and cash flow forecasting
Reviews and analyzes data trends in governmental reimbursements, works with vendors to develop analysis and support on-going and future reimbursements
Enhances and improves analysis to determine the impact of payer mix and changes to operations on governmental reimbursements
Develops recommendations to management
Identifies and reviews analysis involving new business initiatives and models governmental reimbursement impacts
Creates recommendations on policy issues to maintain compliance with regulations and guidelines
Enhances and is proactive in implementing procedures consistent with established policies
Supervises and analyzes current policies and procedures and assesses effectiveness
Oversees and manages special projects
Oversees the preparation of special impact studies and other financial surveys and questionnaires
Ensures professional development and attends educational in-services as appropriate.
Participates in professional activities and organizations to maintain knowledge of current trends, practices, and developments
Reviews, prepares and analyzes statistical reports, financial statements, and supporting schedules for management
Identifies, develops, and implements methods for improving reporting efficiency.
Identifies requirements and develops reports required by state and federal agencies and ensures compliance.
Provides guidance and direction to professional staff
Performs related responsibilities as required
Minimum Qualifications:
6 years related experience required with an MBA or CPA preferred.
Experience in preparation of Medicare and Medicaid cost reports required.
Experience with complex academic healthcare and transplants preferred.
Strong knowledge of Medicare and Medicaid reimbursement regulations.
Excellent analytical and problem-solving skills.
Proven leadership and team management abilities.
Preferred technical qualifications:
Knowledge and experience with Epic, Stratajazz, PeopleSoft, SQL, Power BI, EPSI and Kodiak (RCA).
Education:
A bachelor's degree in accounting, finance, data or business analytics or information systems related field.
Additional Details
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at careers@emoryhealthcare.org . Please note that one week's advance notice is preferred.
Connect With Us!
Connect with us for general consideration!
Division
Emory Healthcare Inc.
Campus Location
Atlanta, GA, 30345
Campus Location
US-GA-Atlanta
Department
EHI Hospitals Finance
Job Type
Regular Full-Time
Job Number
154302
Job Category
Business Operations
Schedule
8a-4:30p
Standard Hours
40 Hours
Hourly Minimum
USD $55.37/Hr.
Hourly Midpoint
USD $76.14/Hr.
Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.