Under general direction, manages and coordinates the activities of the Reimbursement staff which include regulation analysis, development/preparation of cost reports, and contractual allowance calculations.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
1 In conjunction with the Director of Reimbursement, develops short and long-term goals and objectives for the Reimbursement Section.
2 Develops and implements plans to accomplish agreed upon goals.
3 Interviews, hires, trains, evaluates the performance of and, when necessary, disciplines and discharges associates.
4 Oversees the preparation and analysis of third party payor cost reports.
5 Oversees the analysis of tentative and final settlements. Coordinates, researches and analyzes prior year re-openings and appeals.
6 Oversees the preparation of the balance sheet test and assessment of reserve status.
7 Oversees the preparation of analyses regarding current and proposed regulations and advises management on ways to maximize reimbursement.
8 Oversees the preparation and analysis of budget cost reports and contractual allowance for prospective budget package.
9 Oversees the research and analysis of reimbursement issues. Oversees the preparation of financial models and analyses to maximize reimbursement.
10 Oversees project analysis regarding operational issues, new programs, service line expansion, etc.
11 Assists departments to enhance their understanding of hospital reimbursement.
12 Oversees and coordinates third party and year end audits.
13 Develops the staff within the section through internal training.
14 Oversees the development and maintenance of the ARTS system.
15 Supervises preparation of third party payor logs and reconciliation of such logs to related general ledger accounts.
16 Maintains knowledge of current trends and developments in the field by reading appropriate books, journals and other literature and attending related seminars, conferences and the like.
17 Maintains good rapport and cooperative relationships. Approaches conflict in a constructive manner. Helps to identify problems, offer solutions, and participate in their resolution.
18 Maintains the confidentiality of information acquired pertaining to patient, physicians, employees, and visitors to St. Joseph Mercy Hospital. Discusses patient and hospital information only among appropriate personnel in appropriately private places.
19 Behaves in accordance with the Mission, Vision and Values of Saint Joseph Mercy Health System.
20 Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.
REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE
Requires Bachelor's degree in Accounting or related field, or equivalent combination of education and experience.
Five to seven years progressively more responsible related work experience.
REQUIRED SKILLS AND ABILITIES
Professional level of knowledge of hospital accounting, finance, reimbursement and general business administration.