Director ReimbursementAltamonte Springs, FL

Director Reimbursement

Hospitals, medical centers, and facilities need more than physicians, nurses, and specialists delivering care to our patients. A truly successful health care organization needs a thoughtful, dedicated, steady, and experienced team working behind the scenes to make sure communities around the country receive the health care they need.

If you've also been interested in working in the health care field but aren't a health care provider, a corporate career at AdventHealth may just be the perfect fit. We're a faith-based health care organization headquartered in Altamonte Springs, Florida. As a national leader in quality, safety, and patient satisfaction, our 92,000 team members maintain a long tradition of whole-person health by caring for the physical, emotional, and spiritual needs of every patient.

Start your journey with a health care career at AdventHealth Corporate.

Every day, our fellow team members show up to work, unified by one shared mission: Extending the Healing Ministry of Jesus Christ. As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind, and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam, and patient room, we're committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.

The role you will contribute:

The Reimbursement Director directs the Reimbursement Department's financial analysis and reimbursement activities. These activities include preparation and filing the annual Medicare, Medicaid, and Champus/Tricare cost reports; preparation of reopening and appeal papers, audit preparation, and other cost report settlement activity and related analysis for third-party financial statement reporting for the Adventist Health System (AHS). This position collaborates with management in the reimbursement regulations and regulatory, operational, and financial impacts of proposed operational decisions; and serves as subject matter resource for Medicare and Medicaid reimbursement matters. The Director is responsible for creating a work environment that supports a strong team, and challenges team members to continually strive for improvements in work processes. The Director actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

The value you will bring to the team:

• Serve as AHS subject matter resource for Medicare and Medicaid reimbursement matters
• Maintain a strong working knowledge of current laws and regulations of the Federal Medicare and State Medicaid programs, including changes affecting hospital reimbursement of Medicare bad debt, graduate medical education, disproportionate share hospital adjustment, and uncompensated care payments
• Communicate technical positions/arguments effectively to Medicare, Medicaid, and other State or Federal agencies auditors to support positions taken on the hospital cost report, or other required reporting
• Review the Medicare and Medicaid Uniform Contractual Worksheet-Third Party Settlement (UCW-TPS) templates of each AHS hospital according to standardized policies and procedures to properly reflect the financial reporting of third-party balances of AHS
• Prepare year end estimated Medicare and Medicaid third party financial settlement to be audited by AHS external financial auditor for inclusion in the audited financial statements
• Prepare annual Medicare Inpatient and Outpatient net revenue schedules used to prepare hospital annual operating net revenue budget
• Maintain awareness of organizational administrative and operational changes that could impact the hospitals Medicare and/or Medicaid reimbursement
• Direct financial analysis and modeling activities to determine the financial and reimbursement implication of proposed business transactions and changes in regulatory requirements
• Complete special projects assigned by Corporate Leadership within the time frame requested
• Daily supervision of department staff
• Foster an environment that promotes strong team values and cooperation
• Recruit and retain high performance employees
• Prepare annual department budget
• Develop annual department goals
• Hire, dismiss, develop, and evaluate the individual members of the department staff

The expertise and experiences you'll need to succeed:

• Bachelor's Required
• 10 Work Experience Required
• Strong and proven leadership skills
• In-depth knowledge of Medicare and state Medicaid program reimbursement laws and regulations
• Ability to research and interpret Medicare and Medicaid laws and regulations
• Proficient in use of regulatory cost reporting software
• Possess an understanding of financial accounting and auditing principles and their application to healthcare
• Strong computer software skills including Microsoft Office applications
• Ability to learn new technology applications used by Adventist Health System
• Strong analytical reasoning, critical thinking, judgment, and problem solving skills in order to independently assess, interpret, and address complex issues in a continually changing environment
• Effective written and verbal communication skills
• Excellent interpersonal skills
• Well organized and detail-oriented
• Proficient using Health Financial Systems (HFS) cost reporting software

Preferred Qualifications:

• Master's Preferred
• Certified Public Accountant (CPA) Preferred

This facility is an equal opportunity employer and complies with federal, state, and local anti-discrimination laws, regulations, and ordinances.

Category: Accounting/Finance

Organization: AdventHealth Corporate

Schedule: Full-time

Shift: 1 - Day

Req ID: 25029753

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age, or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits, and other terms and conditions of employment.