Director, Reimbursement-Financial Analysis Reimbursement-Corporate 42nd Street-Full-Time-Days
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Job Location:
New York City, NY - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Department:
Job Summary
Director Reimbursement-Financial Analysis Reimbursement-Corporate 42nd Street-Full-Time-Days
The Director is responsible for direction and management responsibility over the business and operational activities of a department (overall department management or a specific area within a department) or medical care unit.
Responsibilities
- Provides superior customer service to internal and external clients customers and patients as referenced in the Service Excellence Standards.
- Oversees the preparation and submission of all regulatory reports.
- Performs direct development and implementation of all NPSR HSN and governmental revenue activities including accruals reserves and settlements at the hospital levels.
- Plans coordinates and prepares year end audits with public accounting firms and third party auditors as they relate to AR operations.
- Mediates and resolves conflicts regarding public accounting firms third party auditors and investigative parties.
- Ensures compliance with relevant regulations standards and directives from regulatory agencies and third party payers.
- Collaborates with other leaders with Steward external agencies vendors and partner organizations to achieve improved financial outcomes.
- Acts as primary contact for all reimbursement issues and advises the financial management team about changes in reimbursement environment and suggest courses of action.
- Trains all new employees about reimbursement issues and system usage.
- Evaluates of all medical education reimbursement calculations which includes scrutinizing all roll forward calculations affiliation agreements and residency caps.
- Reviews all Medicaid and Medicare data to determine Medicare disproportionate share reimbursement.
- Reviews all third-party settlements to ensure their accuracy and standardize their presentation.
- Oversees the preparation and review of each hospitals monthly net revenue modeling and helps to evaluate variances to budget.
- Oversees all audits performed by external firms and/or governmental agencies.
- Prepares responses to both internal and external questions involving various reimbursement matters to ensure a timely and accurate resolution to all issues.
- Interacts with division directors and departmental heads to obtain all data necessary to comply with various regulatory requirements.
- Takes the lead role in reviewing the annual Medicaid RFA to evaluate its impact and coordinate the systems response.
- Assists with the evaluation and resolution of various compliance matters involving federally funded insurers like Medicare and Medicaid.
- Oversees the process to identify Medicare Choice plan discharges so that Medicare senior plan IME billing takes place timely.
- Participates in the evaluation of all managed care proposals to ensure that all proposals will enable the system to cover costs and can be administered effectively.
- Completes annual evaluations for all direct reports.
- Develops the departmental annual operating and capital budgets.
- Creates new policies and procedures resulting from system and/or operational changes.
- Makes all decisions governing hiring promoting demoting and terminating staff.
- Oversees the creation of standardized reports and analyses used to evaluate all RFPs.
Qualifications
- Education: Bachelors degree in either business or financial related field. A Masters degree in business finance or health care related field is preferred.
- Experience: 7 years of experience in health care finance or administration; experience in strategic planning and execution formulating policy building and developing financial plans managing resources and leading successful teams. Big 4 experience a plus. CPA a plus
Non-Bargaining Unit 536 - Reimbursement - MSH Mount Sinai Hospital
Required Experience:
Director
Key Skills
About Company
Strength through Unity and Inclusion The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai’s unparalleled ... View more
