Consultant-Reimbursement-PRN

Baptist•Memphis, TN

About The Position

Job Summary Assists Director for cost reporting and audit support as needed Responsibilities Registers patients accurately, efficiently and professionally to ensure data base integrity and facilitate claims processing. Applies financial screening guidelines to ensure proper procedures are followed in obtaining upfront collections for the specific facility. Strives to expedite patient flow through prompt and courteous service. Completes assigned goals. Performs other duties as assigned, to include health screening. Education Minimum Required BS in Finance, Business or related field. Preferred/Desired Master and/or CPA preferred Job Responsibilities/Essential Functions Assists in compliant reimbursement reporting and optimal revenue achievement from cost reports and modeling from regulations. Helps oversee filing of annual Medicare, Medicaid (including Tennessee Joint Annual Report), and Tricare cost reports along with all audits, surveys, and appeals related to such reports. Tracks cost report process to ensure compliant, accurate, and timely reporting of such reports. Assist in maintenance of 3rd party balance sheet accounts for all entities with costs reporting generated settlements, are maintained and calculates/recommends reserves as needed. Assists Sr. Appeal Manager in the reviews appeals and reopening's requested so as to determine cost/benefit analysis of pursuing with regard to the identified issues. Reviews year-end estimates and all supporting calculations for consistency with each hospital's services. Works with system outside consultants, contractors, and attorneys as needed to support system's hospital government reimbursement activities. Provides guidance to Senior Leadership regarding compliance with new laws/regulations as applied to government reporting requirements. Ensures hospital E.H.R./Meaningful Use attestations are filed timely and provides all documentation needed for hospital MU audits. Serves on association reimbursement-related committees. Reviews rate changes, both facility specific and government published global, for correct contractual calculations within the patient accounting system. Oversees preparation of annual State supplemental & DSH surveys/audits. Evaluates medical education reimbursement information working closely with Chief Academic Officer and Medical Education Staff. Performs other duties assigned. Experience Description : 10 plus years finance leadership with solid background of government reimbursement reporting processes. Experience in multi-hospital healthcare system. Abilities to foster collaborative relationships with key stakeholders. Comprehensive knowledge of all government reimbursement-related regulations including but not limited to Medicare, Medicaid, and Tricare. This includes knowledge of Medicare and Medicaid medical education, transplant, allied health, CAH, 340b, and all other related areas. Must possess strong interpersonal, analytic and organization skills with demonstrated experience leading, managing deadline driven projects, and teams in a fast paced environment.

Requirements

BS in Finance, Business or related field.
10 plus years finance leadership with solid background of government reimbursement reporting processes.
Experience in multi-hospital healthcare system.
Abilities to foster collaborative relationships with key stakeholders.
Comprehensive knowledge of all government reimbursement-related regulations including but not limited to Medicare, Medicaid, and Tricare. This includes knowledge of Medicare and Medicaid medical education, transplant, allied health, CAH, 340b, and all other related areas.
Must possess strong interpersonal, analytic and organization skills with demonstrated experience leading, managing deadline driven projects, and teams in a fast paced environment.

Nice To Haves

Master and/or CPA preferred

Responsibilities

Assists Director for cost reporting and audit support as needed
Registers patients accurately, efficiently and professionally to ensure data base integrity and facilitate claims processing.
Applies financial screening guidelines to ensure proper procedures are followed in obtaining upfront collections for the specific facility.
Strives to expedite patient flow through prompt and courteous service.
Completes assigned goals.
Performs other duties as assigned, to include health screening.
Assists in compliant reimbursement reporting and optimal revenue achievement from cost reports and modeling from regulations.
Helps oversee filing of annual Medicare, Medicaid (including Tennessee Joint Annual Report), and Tricare cost reports along with all audits, surveys, and appeals related to such reports.
Tracks cost report process to ensure compliant, accurate, and timely reporting of such reports.
Assist in maintenance of 3rd party balance sheet accounts for all entities with costs reporting generated settlements, are maintained and calculates/recommends reserves as needed.
Assists Sr. Appeal Manager in the reviews appeals and reopening's requested so as to determine cost/benefit analysis of pursuing with regard to the identified issues.
Reviews year-end estimates and all supporting calculations for consistency with each hospital's services.
Works with system outside consultants, contractors, and attorneys as needed to support system's hospital government reimbursement activities.
Provides guidance to Senior Leadership regarding compliance with new laws/regulations as applied to government reporting requirements.
Ensures hospital E.H.R./Meaningful Use attestations are filed timely and provides all documentation needed for hospital MU audits.
Serves on association reimbursement-related committees.
Reviews rate changes, both facility specific and government published global, for correct contractual calculations within the patient accounting system.
Oversees preparation of annual State supplemental & DSH surveys/audits.
Evaluates medical education reimbursement information working closely with Chief Academic Officer and Medical Education Staff.
Performs other duties assigned.