MANAGER OF REIMBURSEMENT (Whitesville,KY)

Oversees all reimbursement functions.Coordinates the preparation and documentation of Medicare and Medicaid cost reports and related filings.Maintains adequate schedules and analysis to support settlement accounts.Prepares appeals and re-openings of Medicare and Medicaid cost reports, and coordinates the accurate settlements of all issues.Coordinates support for audits of cost reports and other third party filings.Prepares pro forma cost reports or other analysis to evaluate proposed regulatory changes as needed.Prepares other reports, such as the IRIS report, the Blue Cross report, Medicaid DSH filings, and ad hoc external reports.Supports the development of hospital and Owensboro Health budgets and the calculations of revenue deductions, contractual allowances, bad debt and other reserves and settlement accounts as requested.Maintains sufficient knowledge of System operations and Federal and State regulations to ensure compliance with all laws.Coordinates revenue maximization and initiatives and lead Finance input into compliance initiatives throughout Owensboro Health with respect to governmental programs.Represents Owensboro Health in consultations with the Kentucky Medicaid program around reimbursement programs, including DSH. Coordinates with CFOs of other major Kentucky health systems, the Kentucky Hospital Association and outside counsel.Contributes to development and maintenance of all department and hospital system enhancements as required, including revenue modeling.Ensures adherence to all third party reporting requirements.Maintains necessary technical application skills.Reviews, analyzes and makes recommendations on proposed legislation. Authors comment letters on such legislation on behalf of Owensboro Health.Supports, through analysis and reporting, the Owensboro Health seat on the Medicaid Technical Advisory Committee as directed by the Vice President of Finance.Completes all provider based applications, Medicare 855s, financial analyses and other projects under the direction of the Vice President of Finance.Works collaboratively with the Owensboro Health Managed Care staff to ensure contract compliance and successful implementation of any Medicaid and Medicare managed care agreements.Manages staff relations including performance management, staff satisfaction and conflict management.Performs and oversees scheduling, recruitment, and payroll.Organizational Responsibilities