Manager Reimbursement - Accounting at Christus Health

Responsibilities

• Prepare and review monthly contractual allowance journal entries and supporting calculations and responsible for proper balances in associated income statement and balance sheet accounts, for multiple facilities
• Analyze monthly contractual allowance variances, providing detailed explanations for significant fluctuations to Hospital Administration for use during close meetings
• Maintain current, correct account analysis' related to program Income Statement and Balance Sheet accounts
• Ensure monthly reports are prepared timely and accurately by supporting departmental Associates
• Prepare final hospital and home office cost reports, completing comparative analysis of the cost report versus the financial statement and compliance checklist prior to submission, for multiple facilities
• Ensure Medicare, Medicaid and CHAMPUS cost reports are submitted by due dates to prevent loss of reimbursement to the facilities
• Identify and pursue proper reimbursement methodologies in an effort to receive all reimbursement due based upon Medicare, Medicaid and CHAMPUS Regulations
• Cook up and review Medicare Field Audits, ensuring complete, proper and timely information is provided and audit adjustments are reviewed prior to issuance of the settlement
• Errors found must be communicated in writing to the Auditors during the audit, to ensure proper settlement and issuance of the Notice of Program Reimbursement
• Prepare audit adjustment analysis to determine reimbursement impact of adjustments to as filed report
• Act as a liaison to the External Financial Auditors for both the interim and final audits, for multiple facilities
• Review settled cost reports prior to final reopening deadlines to ensure the reports were appropriately settled
• Prepare and submit cost report reopening requests to obtain additional reimbursement due and otherwise make requests for corrections as appropriate
• Prepare and submit appeals and subsequent position papers to appeal inappropriate settlements with the PRRB, for assigned facilities
• Assist in preparation of Social Accountability and Community Needs reports required as part of annual budget process
• Respond to requests from Hospital Administration and other internal and hospital departments in areas where reimbursement knowledge is required
• Analyze and inform Hospital Administration of financial impact of operational decisions, as requested
• This may include preparation of pro-forma analysis and due diligence for new and existing business opportunities and informing Management and Hospital Administration of proposed/final rules and Regulations, which could impact the hospitals' operations
• Aid in preparation of cash reconciliation process for settlements and interim payments
• This includes identifying and communicating errors or issues found to these departments
• Maintain knowledge of current trends and developments in the field by reading appropriate books, journals, and attending related seminars and conferences
• Actively participate as a member in HFMA as a representative of CHRISTUS Health
• Aid in authoring thorough, accurate policies and procedures for standardized and transparent processes
• Aid in maintaining rate tables for Medicare, Traditional Medicaid and CHAMPUS in an effort to ensure proper payments are received
• Monitor interim payment rates and work with the Intermediary to ensure proper payments are being made
• Participate on the performance initiative to track, review and reduce denials
• Collaborate on cross-functional teams to address System standardization needs of processes where reimbursement expertise is required

Requirements

• Bachelor's Degree required