Cost Report Reimbursement Manager

Avera Downtown Building-Sioux Falls

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Pay Range:

The pay range for this position is listed below. Actual pay rate dependent upon experience.

$90,480.00 - $135,200.00

Position Highlights

This position is located in Sioux Falls, SD!

May be eligible for $5,000 sign-on and relocation assistance.

Seeking a candidate with 5+ years of Medicare Cost Reporting experience.

Avera offers competitive salary and benefits!

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

A Brief Overview

The Cost Report Reimbursement Manager will be responsible for the oversight of reimbursement associated with the Medicare, Medicaid, Tricare and any other governmental cost reports and regulatory support for Avera Health hospitals, clinics, home healths, hopices, and nursing homes. Oversight includes the Medicare, Medicaid and Tricare cost reports for all entities in the Avera system.

What you will do

• Accountable to the completion of the monthly Medicare 3rd Party Settlement calculation for all hospitals.
• Assist in the development and calculations of the annual revenue deductions and uncompensated care budget for all Avera hospitals, clinics, and nursing.
• Manage and maintain workflows for filing and review of Medicare, Medicaid and Tricare cost reports for the assigned Avera region.
• Maintain oversight of the collection of the cost report information for the assigned locations and oversight of the governmental audits of all facilities.
• Complete all requests for data and support documentation during the annual audit of financial statements for the 3rd party reserves for all Avera Health hospitals.
• Responsible to monitor and interpret the state and federal regulatory publications and announcements, providing impact analysis for all Avera hospitals, clinics, nursing homes and other patient operating units.
• Provide expertise, guidance, and advice to the rural network on reimbursement issues and cost report impacts as requested.
• Assist as the financial liaison to stakeholders in all Avera regions regarding reimbursement matters/issues, general compliance, and charge master compliance relative to Medicare cost reporting.
• Collaborate with Finance, Decision Support, and the Revenue Cycle by offering direction/guidance on reimbursement issues/concerns.

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.

Required Education, License/Certification, or Work Experience:

• Bachelor's Accounting, Business, Finance or related field
• 4-6 years experience in the healthcare environment with regulatory and cost reporting experience.

Preferred Education, License/Certification, or Work Experience:

• Master's Accounting, Business, Finance or related field
• Certified Public Accountant (CPA) - Board of Accountancy Upon Hire
• Experience in all reimbursement settings such as, Prospective Payment Hospitals (PPS), Sole Community Hospitals (SCH), Critical Access Hospital (CAH), Rural Health Clinics (RHC), Skilled Nursing Facility (SNF).
• Experience with IME, GME, Transplant, DSH, and Wage Index is a plus.

Expectations and Standards

• Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
• Promote Avera’s values of compassion, hospitality, and stewardship.
• Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
• Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Benefits You Need & Then Some

Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.

• PTO available day 1 for eligible hires.

• Free health insurance options, for full-time single coverage on Avera High Deductible Health Plan

• Up to 5% employer matching contribution for retirement

• Career development guided by hands-on training and mentorship

Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.