Manager - Reimbursement

Description

Management/Leadership
Req #: 45183

Summary:
The Manager - Reimbursement position will be responsible for the development and coordination of reimbursement strategies that enable successful contributions to company objectives. Providing insights to increasingly complex dynamics of market and government reimbursement changes, this position will serve as an integral lead on assessment, projection and reporting on payment objectives. * * Under the direction of the Vice President of Finance, and in partnership with the Vice President of Reimbursement, Accounting and Finance, Corporate Contracting, and Central Billing Office leadership, the Manager - Reimbursement will participate in the direct on-going support, analysis, and examine opportunities for improvement as it relate to healthcare reform, trends, and payor relations for MH Professional Billing entities. * * The scope of responsibility includes aspects of monitoring payor performance, operational integrity, revenue cycle and benchmarking collaboration. Furthermore, the position will assist Finance in the completion of yearly contractual allowance budgeting, support the work in the underpayment audits, analysis and recovery functions, and physician profiling in an effort to optimize global reimbursement targets. The manager will have the support and obligation to supervise and train reimbursement department staff.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

1. Education: BS required; CPA, MBA, HFMA preferred or equivalent specific experience in practice reimbursement.
2. License/Certifications: N/A
3. Experience: Three to Five years' experience in physician reimbursement required to include estimating contractual allowances and third party payables/receivables.
4. Previous leadership experience preferred.
5. Interpersonal skills necessary to communicate effectively with both internal and external customers.
6. Ability to problem solve and work cooperatively with other hospital departments, physicians, local Finance teams and the System's reimbursement team and management.
7. Ability to compile, analyze, interpret, and present complex analytical reimbursement and financial analysis reports, statements, and /or projections. Certification in health system billing modules is required.
8. Ability to gather and analyze statistical data and generate reports related to provider reimbursement. Knowledge and understanding of laws, regulations and documentation requirements for the management and reporting of medical reimbursement related information.
9. Knowledge of a range of automated financial systems and information application software.

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