Mgr Ent Reimbursement

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. This position is responsible for ensuring that all WVUHS hospitals are in compliance with all state and federal regulatory reporting requirements relating to reimbursement. Extensive knowledge of third party reimbursement regulations is required. This position is also responsible for managing net revenue, development of budget, reserve analysis and identifying and implementing revenue enhancement opportunities. This position is responsible for ensuring that all WVUHS hospitals are in compliance with all state and federal regulatory reporting requirements relating to reimbursement. Extensive knowledge of third party reimbursement regulations is required. This position is also responsible for managing net revenue, development of budget, reserve analysis and identifying and implementing revenue enhancement opportunities. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Bachelor’s Degree in Business with a major in Accounting or Finance. EXPERIENCE: 1. Five (5) years of experience in healthcare finance or accounting. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. MBA or CPA. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Ensures that all Hospitals are in compliance with all state and federal regulations related to reimbursement 2. Manages the preparation and analytical review of all external Medicare Cost Reports, WV HCA filings and all other state or federal reimbursement filings for all hospitals 3. Reviews and analyzes all state and federal reimbursement regulations to ensure compliance and presents financial impact of changes in regulations 4. Communicates directly with external auditors, third party payors and WV HCA staff in regard to financial matters. 5. Coordinates the development of the net revenue budget 6. Establishes a process for ongoing monitoring of gross and net revenue, including an analysis of reserves for contractuals, bad debt and charity 7. Coordinates with patient financial services and accounting the processing of changes in third party payment requirements and the impact on financial reporting and financial statements 8. Ensures that the financial terms of managed care contracts are thoroughly and accurately analyzed and monitored 9. Ensures that the long range financial planning process includes accurate and up to date reimbursement assumptions 10. Coordinates projects related to revenue enhancement opportunities 11. Works with legal counsel and the fiscal intermediary to identify and resolve outstanding Medicare appeal issues. 12. Develops and maintains an ongoing staff development program and an orientation program for the reimbursement staff 13. Consistently monitors and documents performance of staff members and utilizes appropriate reward and disciplinary measures as needed 14. Demonstrates an ability to create an atmosphere that fosters motivation of staff to work at optimal efficiency and encourages staff to regularly establish and achieve departmental goals 15. Provides leadership and direction to professional staff and maintains a professional working relationship with all staff, always responds to staff concerns in a professional and timely manner; maintains appropriate interdepartmental communication PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. SKILLS AND ABILITIES: 1. Effective verbal and written communications skills and strong interpersonal skills are required 2. Extensive knowledge of personal computers, Excel software is desirable MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Bachelor’s Degree in Business with a major in Accounting or Finance. EXPERIENCE: 1. Five (5) years of experience in healthcare finance or accounting. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. MBA or CPA. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Ensures that all Hospitals are in compliance with all state and federal regulations related to reimbursement 2. Manages the preparation and analytical review of all external Medicare Cost Reports, WV HCA filings and all other state or federal reimbursement filings for all hospitals 3. Reviews and analyzes all state and federal reimbursement regulations to ensure compliance and presents financial impact of changes in regulations 4. Communicates directly with external auditors, third party payors and WV HCA staff in regard to financial matters. 5. Coordinates the development of the net revenue budget 6. Establishes a process for ongoing monitoring of gross and net revenue, including an analysis of reserves for contractuals, bad debt and charity 7. Coordinates with patient financial services and accounting the processing of changes in third party payment requirements and the impact on financial reporting and financial statements 8. Ensures that the financial terms of managed care contracts are thoroughly and accurately analyzed and monitored 9. Ensures that the long range financial planning process includes accurate and up to date reimbursement assumptions 10. Coordinates projects related to revenue enhancement opportunities 11. Works with legal counsel and the fiscal intermediary to identify and resolve outstanding Medicare appeal issues. 12. Develops and maintains an ongoing staff development program and an orientation program for the reimbursement staff 13. Consistently monitors and documents performance of staff members and utilizes appropriate reward and disciplinary measures as needed 14. Demonstrates an ability to create an atmosphere that fosters motivation of staff to work at optimal efficiency and encourages staff to regularly establish and achieve departmental goals 15. Provides leadership and direction to professional staff and maintains a professional working relationship with all staff, always responds to staff concerns in a professional and timely manner; maintains appropriate interdepartmental communication PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. SKILLS AND ABILITIES: 1. Effective verbal and written communications skills and strong interpersonal skills are required 2. Extensive knowledge of personal computers, Excel software is desirable Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Exempt) Company: WVUH West Virginia University Hospitals Cost Center: 540 SYSTEM Finance and Reimbursement WVU Medicine recently moved to a new Applicant Tracking System. If you are unable to login, please create a new account to apply. Thank you for your interest in working for WVUM. Please explore our open opportunities in the list below and apply for any positions in which you would like to be considered. You'll be able to keep track of your progress on our site. The West Virginia University Health System, West Virginia's largest health system with more than 1,800 beds and largest private employer, is comprised of 16 member hospitals, including a children's hospital; three managed hospitals; and five institutes, all anchored by a 700-bed academic medical center in Morgantown, West Virginia.