Job Abstract

Salary Range: $130,062 - $182,062

The Reimbursement Manager will ensure that cost reports and other reimbursement related reports, as required, for government payors are accurate and filed timely. Accurately calculates monthly contractual reserve and bad debt allowances and assists in forecasting contractual and bad debt rates to be used for annual budget process. Reviews and interprets contracts and provides input to senior management regarding potentials for increased reimbursement.
In addition to performing the essential functions listed below, may also be assigned other duties as required.

Education 
Required: Bachelor's Degree
Preferred: Master's Degree; Certified Public Accountant
Experience
Required: 5 years of hospital or healthcare financial and reimbursement experience Preferred: 2 years audit experience with Federal (Medicare) or State (Medi-Cal) fiscal intermediary.
Skills: Required: Strong Excel spreadsheet knowledge, including ability to work with large data files.

1. Prepares monthly calculation of contractual reserve and bad debt allowances, for recording in the hospital's financial statements, in accordance with relevant GASB and FASB guidance. Maintains supporting documentation and provides related reports or analyses, as requested.
2. Responds to reimbursement-related requests as part of the annual hospital financial audit, including preparation of various schedules and providing related supporting documentation. External auditor proposes no changes to the recorded reserves.
3. ·Assists with calculation of contractual and bad debt rates for annual hospital budget.
4. Responsible for annual cost report preparation and works with outside consultants, as needed, to resolve and/or appeal cost report findings.
5. Assists with the periodic reconciliation of Net Revenue and the general ledger.
6. Prepares all other reports as requested by Finance management and/or other internal and external parties.
7. Results for all of the above must be accurate, timely, useful and relevant.

Demonstrates Skills:

1. Capably utilizes various computer software, including Microsoft Excel and Word, other Windows applications, and Medicare/MediCal cost reporting software.
2. Exhibits advanced knowledge of day-to-day hospital operational and financial activities.
3. Demonstrates knowledge of Medicare and Medi-Cal principles of reimbursement.
4. Displays excellent problem-solving and analytical abilities.

Planning & Coordinating

1. Continually strives to improve and streamline overall reimbursement analyses and activities.
2. Works closely with other key personnel, including from Financial Planning & Analysis and Patient Accounting to align definitions, categorization and calculations related to reimbursement.
3. Demonstrates ability to organize projects, prioritize and complete duties on a timely basis with minimal direct supervision.

Professionalism

1. Exhibits good judgment in interactions with internal and external customers.
2. Possesses and utilizes good oral and written communication skills.
3. Observes hospital safety guidelines, policies and procedures.
4. Attends and/or completes required safety and disaster training.
5. Attends/Completes required annual education modules

Professional

1. Exhibits good judgment in interactions with internal and external customers.
2. Possesses and utilizes good oral and written communication skills.
3. Observes hospital safety guidelines, policies and procedures.
4. Attends and/or completes required safety and disaster training.
5. Attends/Completes required annual education modules.

Improving the Organization

1. Makes suggestions for improvement based on personal observations, where appropriate.
   2. Willingly participates on process improvement initiatives, when asked or assigned.

Self-Development

1. Identifies/attends optional educational programs related to job requirements.

Regulatory Compliance

1. Accurately prepares annual Medicare and Medi-Cal cost reports in compliance with applicable regulations.
2. Monitors reimbursement data and publications for relevant changes in Federal and State regulations.
3. Communicates changes, and the related implications, on a timely basis, in a clear and concise manner, to relevant personnel.

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