As the Manager of Reimbursement you will be responsible for obtaining proper Medicare, Medicaid and other third-party cost based reimbursement for hospitals within Ardent's system. This vital role ensures hospital compliance with Ardents standard third-party accounting system, and is a key contributor to the organization's financial success.
Education: BBA or BS in Accounting, Finance or Business
Experience: 3-5 years Medicare reimbursement experience, preferably with acute care hospitals
1. Prepares annual Medicare, Medicaid and other third-party cost reports in compliance with rules and regulations of the respective third-party program.
2. Defends filed cost report, as appropriate, during the annual cost report audit.
3. Protects appeal rights for cost report audit adjustment(s) by ensuring compliance with required administrative appeal procedures and provides support during the appeal process.
4. Provides support to assigned hospitals for calculation of monthly contractual adjustments. Reviews such calculations for accuracy and propriety.
5. Monitors interim Medicare payments to assigned hospitals to ensure that such payments reflect estimated cost-based reimbursement for the respective accounting period.
6. Monitors local hospital compliance with Ardents standard third-party accounting system.
7. Maintains appropriate level of expertise in the area of Medicare and Medicaid reimbursement. Monitors regulatory changes in such programs and assists in maintaining Ardents compliance with such program rules and regulations.
8. Works with external auditors in their conduct of interim and annual financial audit activities.
9. Supports hospital acquisition activities by actively participating in the due diligence process via evaluation of third-party reimbursement issues related to the acquisition candidate.
10. Assists in preparing annual hospital operations budget for contractual adjustments.
11. Provides decision support to operations management to evaluate hospital operations to achieve optimum financial results.
12. Develops and maintains good working relationships with Intermediaries / governmental agencies.
13. Develops and maintains good working relationships with Ardent Corporate, Group, and local hospital personnel.
14. Assists in review of work performed by Ardents Reimbursement staff.
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