Director, Reimbursement

Facility: Ardent Corporate OfficeRequired Education: Not SpecifiedJob Description:
Position SummaryResponsible for, but not limited to, preparation and review of annual Medicare, Medicaid and other third-party cost reports in full compliance of federal and state regulations and company policies and procedures; cost report audits and appeals; providing technical and analytical support on reimbursement related issues; research and impact analysis of current and future regulations and reporting requirements; month-end and annual reviews of current and prior cost reporting period retroactive settlement accounts; and technical and analytical support during annual forecasting process.
REQUIREMENTS
QualificationsEducation:
BBA or BS in Accounting, Finance or BusinessWork Experience:5 - 10 years experience in healthcare accounting and/or healthcare analytical experience; 5+ years working directly with Medicare cost reports.PRIMARY RESPONSIBILITIES1. Review of annual Medicare, Medicaid and other third-party cost reports in full compliance of federal and state regulations and company policies and procedures.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. Monitors interim Medicare payments to assigned hospitals to ensure that such payments reflect estimated cost-based reimbursement for the respective accounting period.5. Monitors local hospital compliance with Ardent’s standard third-party accounting system.6. Maintains appropriate level of expertise in the area of Medicare and Medicaid reimbursement. Monitors regulatory changes in such programs and assists in maintaining Ardent’s compliance with such program rules and regulations and communicating respective implications.7. Works with external auditors in their conduct of interim and annual financial audit activities.8. Supports hospital acquisition activities by actively participating in the due diligence process via evaluation of third-party reimbursement issues related to the acquisition candidate.9. Assists in preparing annual hospital operations forecast model for contractual adjustments and annual budget procedures.10. Provides decision support to operations management to evaluate hospital operations to achieve optimum financial results.11. Develops and maintains good working relationships with Intermediaries / governmental agencies.12. Develops and maintains good working relationships with Ardent Corporate, Group, and local hospital personnel.13. Assists in review of work performed by Ardent’s Reimbursement staff.14. Performs other duties as assigned while working with limited supervision.15. Attend Monthly Operating Reviews as determined necessary.16. Illustrate strong work ethic and leadership skills.EOE