Associate Director Reimbursement-Financial Analysis Reimbursement-Corporate 42nd Street-Full-Time-Days

Mount Sinai Health System•New York, NY

5d•Onsite

About The Position

Ensures maximization of Reimbursement for the two facilities (BIMC and the Singer Foundation) through the preparation, development, and analytical review of statistical and financial reports to be submitted to Third Party Payers abiding by Federal, State and Blue Cross reimbursement regulations and Generally Accepted Accounting Principles.

Requirements

Bachelor degree in Health Care Administration, Finance or Accounting. Applicable work experience may be considered in lieu of educational requirements.
Approximately three to four years of progressively more responsible related work in a health care institution, fiscal intermediary, or Public Accounting Firm involved in health care auditing.
Thorough knowledge of Reimbursement Regulations and principles as set forth in the Health Care Financial Administration Publication 15-1, the Federal Register, and Part 86-1 of the Commissioner of Health's Rules and Regulations.
In-depth knowledge of the Institutional Cost Report, the Blue Cross Supplement and New York State Supplement, the Provider and Provider Based physician questionnaires, the prospective payment system and case payment system.
Interpersonal skills necessary to direct activities of subordination personnel and to deal effectively with various Hospital departments, outside auditors and agencies and other health care providers.

Responsibilities

Reviews all rate calculations received from various Third Party Payers, ensuring the accuracy of data.
Prepares appeals to various Third Party Payers, stating the Institutions position on proposed changes to the reimbursement regulations.
Analyzes and maintains the monthly activity for the Blue Cross Medicare and Medicaid rate accounts/suspense accounts.
Analyzes the monthly activity and prepares schedules for the Bad Debt and Charity Care Pool accounts, recording and reviewing all payments and distributions made to and from the Pools.
Develops charges for various inpatient and outpatient services for the two Institutions, gathering all the cost information involved with the service and ensure that the developed charge is comparable to other Health Care Institutions.
Prepares cash budget for the department.
Trains and assigns work of staff.
Responsible for updating department with all new regulations and proposed changes to the Medicare Reimbursement System, as set forth in the Health Care Financial Administration Publication 15-1, the Federal Register, and Part 86-1 of the Health's Rules and Regulations.
Interfaces with auditors from fiscal intermediary and independent accounting firm to ensure the proper presentation of the facilities Revenues and Expenses and balance sheet items in the annual financial statements and Institutional Cost Report.
Interfaces with auditors from fiscal intermediary and independent accounting firm to ensure the proper presentation of the facilities Revenues and Expenses and balance sheet items in the annual financial statements and Institutional Cost Report.