Manager Enterprise Reimbursement - Net Revenue PB

WVU Medicine•Home Work - Monroe County WV (Remote), WV

About The Position

This position ensures that all WVUHS hospitals comply with state and federal regulatory reporting requirements related to reimbursement. It requires extensive knowledge of third-party reimbursement regulations and is responsible for managing net revenue, developing the budget, analyzing reserves, and identifying and implementing revenue enhancement opportunities. The role manages reimbursement filings and related financial analysis, coordinates revenue budgeting and monitoring, and works with internal departments, external auditors, third-party payors, WV HCA staff, legal counsel, and the fiscal intermediary. It also leads and develops reimbursement staff, monitors their performance, and supports effective departmental communication and goal setting.

Requirements

Bachelor’s degree in Business with a major in Accounting or Finance.
Five years of experience in healthcare finance or accounting.
Effective verbal and written communication skills.
Strong interpersonal skills.
Extensive knowledge of personal computers; Excel software knowledge is desirable.

Nice To Haves

MBA or CPA.
Knowledge of Excel software.

Responsibilities

Ensure that all hospitals comply with state and federal regulations related to reimbursement.
Manage the preparation and analytical review of external Medicare Cost Reports, WV HCA filings, and other state or federal reimbursement filings for all hospitals.
Review and analyze state and federal reimbursement regulations, ensure compliance, and present the financial impact of regulatory changes.
Communicate with external auditors, third-party payors, and WV HCA staff regarding financial matters.
Coordinate development of the net revenue budget.
Establish ongoing monitoring of gross and net revenue, including analysis of reserves for contractuals, bad debt, and charity.
Coordinate with patient financial services and accounting on processing changes in third-party payment requirements and their impact on financial reporting and financial statements.
Ensure financial terms of managed care contracts are thoroughly and accurately analyzed and monitored.
Ensure long-range financial planning includes accurate, up-to-date reimbursement assumptions.
Coordinate projects related to revenue enhancement opportunities.
Work with legal counsel and the fiscal intermediary to identify and resolve outstanding Medicare appeal issues.
Develop and maintain staff development and orientation programs for reimbursement staff.
Monitor and document staff performance and use appropriate rewards and disciplinary measures as needed.
Create an atmosphere that motivates staff to work efficiently and encourages them to establish and achieve departmental goals.
Provide leadership and direction to professional staff, maintain professional working relationships, respond to staff concerns professionally and promptly, and maintain appropriate interdepartmental communication.