Senior Manager - Reimbursements

Overview

Manages the Reimbursement Section. Develops and maintains reports and performs reimbursement and third-party financial analyses.

Responsibilities

Prepares Medicare Cost reports and all supporting documentation for wage index, and occupational mix submissions. Prepares documentation for appeals and reopening request.

Prepares Medicaid DSH filings, Medicaid Enhancement Tax filings and provides documentation and support to external auditors.

Ensure adequacy of all third-party reserves.

Develop and implement policies and procedures to ensure cost reports are submitted accurately and timely.

Keep up to date with changes in proposed federal and state rule making, inform Senior leaders of changes.

Maintain a comprehensive understanding of net revenue calculations, reimbursement methodologies, compliance issues, including a working knowledge of Medicare & Medicaid payment rules and regulations. Ensure financial statements reflect proper recognition of net revenue for government payers.

Assist in the development of the annual revenue budgets and quarterly forecasts. Provides assistance in the calculation of net revenues for product line profitability, and other ad hoc analysis.

Provides documentation and support to external auditors for year-end financial statements and for other audits pertaining to the Medicare Cost Report.

9 Provides analysis and support to internal and external customers who request assistance related to government payments. Customers may include, but are not limited to the Office of Government Relations, Operations, Compliance,Administration, Finance, Contracting, RMD, the New Hampshire Hospital Association, (NHHA), consultants and law firms.

Reviews regulatory changes and proposals for financial impact, and provides analysis and support for other special projects related to regulatory issues.

Qualifications

• Bachelor's degree in Business Administration with 5 years of experience in hospital financial management with a solid background in general accounting/hospital reimbursement required.
• Excellent interpersonal skills and ability to use a computer required.