What are the responsibilities and job description for the Reimbursement Manager - Reimbursement and Revenue Integrity - FT - Days - MHS position at Memorial Healthcare System?
Location:
Fort Lauderdale, Florida
At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.
Summary
The Reimbursement Manager completes tasks as assigned to assist Directors and the Vice President of Reimbursement & Revenue Integrity with: Medicare and Champus cost reporting and audits, interim rate and settlement calculations, Medicaid waiver reports, maintenance of net revenue preparation and analysis, and various other projects.
Responsibilities
Stay current with the Medicare/Medicaid and other third party payor regulations and determining the impact to the System. Monitor and research state and federal requirements to ensure adequate understanding of compliance issues and opportunities and to ensure timely communication to all affected parties.Participate in the preparation, input, and analysis of the annual Medicare, Medicaid and Champus cost reports. Provide analytical support for the timely and accurate preparation of the cost reports, including information for the preparation of the cost reports, audit schedules, and account reconciliations. Monitor and maintain various cost report statistics such as time studies, meal count and square footage. Coordinate outside audit responses and efforts of outside consultants responsible for Medicare Disproportionate Share Hospital (DSH) payments, Medicare Bad Debt, Medicare Appeals, and review of Medicare Indirect Medical Education (IME) and Graduate Medical Education (GME) payments. Develop responses to Medicare reviews including Wage Index and Occupational Mix Survey.Compile and analyze Medicaid DSH and Low Income Pool (LIP) supporting schedules and final reports. Draft related audit responses. Develop strategic plans for future payment enhancements.Prepare monthly close and annual financial statement documents related to net revenue and supports annual accounting audit of same. Function as primary backup to the Directors in the monthly close process.Maintains roll forward schedule of third-party settlement balances and their application as part of the monthly close process and annual financial audit.Review and approval of outside consultant invoices for Medicare Transfer reimbursement improvements.
Competencies
ACCOUNTABILITY, ACCOUNTING - COST REPORTS, ACCURACY, CUSTOMER SERVICE, FINANCIAL ANALYSIS, HEALTHCARE REGULATORY ENVIRONMENT, REGULATORY COMPLIANCE, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, WORKLOAD MANAGEMENT
Education And Certification Requirements
Bachelors (Required)
Additional Job Information
Complexity of Work: This role requires critical thinking skills, effective communication, decisive judgment, and the ability to build and foster positive relationships. The incumbent must be able to lead others and take appropriate action when required. Essential to have thorough knowledge of Medicare, Medicaid and Champus rules and regulations and Third party audit techniques. Proficient in Microsoft Office products and Cost Reporting Software. Required Work Experience: Five (5) years of progressively responsible experience in hospital reimbursement operations, audit or consulting including projects specifically related to Medicare and Medicaid reimbursement.
Working Conditions And Physical Requirements
Primarily for office workers - not eligible for shift differential
Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.
Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.
Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.
Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.
We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.
Employment is subject to post offer, pre-placement assessment, including drug testing.
If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net
Fort Lauderdale, Florida
At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.
Summary
The Reimbursement Manager completes tasks as assigned to assist Directors and the Vice President of Reimbursement & Revenue Integrity with: Medicare and Champus cost reporting and audits, interim rate and settlement calculations, Medicaid waiver reports, maintenance of net revenue preparation and analysis, and various other projects.
Responsibilities
Stay current with the Medicare/Medicaid and other third party payor regulations and determining the impact to the System. Monitor and research state and federal requirements to ensure adequate understanding of compliance issues and opportunities and to ensure timely communication to all affected parties.Participate in the preparation, input, and analysis of the annual Medicare, Medicaid and Champus cost reports. Provide analytical support for the timely and accurate preparation of the cost reports, including information for the preparation of the cost reports, audit schedules, and account reconciliations. Monitor and maintain various cost report statistics such as time studies, meal count and square footage. Coordinate outside audit responses and efforts of outside consultants responsible for Medicare Disproportionate Share Hospital (DSH) payments, Medicare Bad Debt, Medicare Appeals, and review of Medicare Indirect Medical Education (IME) and Graduate Medical Education (GME) payments. Develop responses to Medicare reviews including Wage Index and Occupational Mix Survey.Compile and analyze Medicaid DSH and Low Income Pool (LIP) supporting schedules and final reports. Draft related audit responses. Develop strategic plans for future payment enhancements.Prepare monthly close and annual financial statement documents related to net revenue and supports annual accounting audit of same. Function as primary backup to the Directors in the monthly close process.Maintains roll forward schedule of third-party settlement balances and their application as part of the monthly close process and annual financial audit.Review and approval of outside consultant invoices for Medicare Transfer reimbursement improvements.
Competencies
ACCOUNTABILITY, ACCOUNTING - COST REPORTS, ACCURACY, CUSTOMER SERVICE, FINANCIAL ANALYSIS, HEALTHCARE REGULATORY ENVIRONMENT, REGULATORY COMPLIANCE, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, WORKLOAD MANAGEMENT
Education And Certification Requirements
Bachelors (Required)
Additional Job Information
Complexity of Work: This role requires critical thinking skills, effective communication, decisive judgment, and the ability to build and foster positive relationships. The incumbent must be able to lead others and take appropriate action when required. Essential to have thorough knowledge of Medicare, Medicaid and Champus rules and regulations and Third party audit techniques. Proficient in Microsoft Office products and Cost Reporting Software. Required Work Experience: Five (5) years of progressively responsible experience in hospital reimbursement operations, audit or consulting including projects specifically related to Medicare and Medicaid reimbursement.
Working Conditions And Physical Requirements
- Bending and Stooping = 0%
- Climbing = 0%
- Keyboard Entry = 60%
- Kneeling = 0%
- Lifting/Carrying Patients 35 Pounds or Greater = 0%
- Lifting or Carrying 0 - 25 lbs Non-Patient = 60%
- Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%
- Lifting or Carrying > 75 lbs Non-Patient = 0%
- Pushing or Pulling 0 - 25 lbs Non-Patient = 0%
- Pushing or Pulling 26 - 75 lbs Non-Patient = 0%
- Pushing or Pulling > 75 lbs Non-Patient = 0%
- Reaching = 40%
- Repetitive Movement Foot/Leg = 0%
- Repetitive Movement Hand/Arm = 0%
- Running = 0%
- Sitting = 20%
- Squatting = 0%
- Standing = 0%
- Walking = 0%
- Audible Speech = 0%
- Hearing Acuity = 0%
- Smelling Acuity = 0%
- Taste Discrimination = 0%
- Depth Perception = 0%
- Distinguish Color = 0%
- Seeing - Far = 60%
- Seeing - Near = 0%
- Bio hazardous Waste = 0%
- Biological Hazards - Respiratory = 0%
- Biological Hazards - Skin or Ingestion = 0%
- Blood and/or Bodily Fluids = 0%
- Communicable Diseases and/or Pathogens = 0%
- Asbestos = 0%
- Cytotoxic Chemicals = 0%
- Dust = 20%
- Gas/Vapors/Fumes = 0%
- Hazardous Chemicals = 0%
- Hazardous Medication = 0%
- Latex = 0%
- Computer Monitor = 60%
- Domestic Animals = 0%
- Extreme Heat/Cold = 0%
- Fire Risk = 0%
- Hazardous Noise = 0%
- Heating Devices = 0%
- Hypoxia = 0%
- Laser/High Intensity Lights = 0%
- Magnetic Fields = 0%
- Moving Mechanical Parts = 0%
- Needles/Sharp Objects = 0%
- Potential Electric Shock = 0%
- Potential for Physical Assault = 0%
- Radiation = 0%
- Sudden Decompression During Flights = 0%
- Unprotected Heights = 0%
- Wet or Slippery Surfaces = 0%
Primarily for office workers - not eligible for shift differential
Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.
Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.
Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.
Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.
We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.
Employment is subject to post offer, pre-placement assessment, including drug testing.
If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net