Assists with the direction and supervision of the overall operation of the Budget and Reimbursement functions. Works within the department and as a part of the Medical Center’s management team to operationalize the patient care and service goals and objectives established by senior management.
- Assists in the development of the annual statistical, revenue, salary, supply and expense budgets for the Medical Center under the direction of the Director or Budget, Reimbursement and Managed Care and Vice President of Revenue Cycle. Generates routine and on demand budget reports for review with Senior Management. Prepares statistics, expense and revenue monthly spreads for the budget and reviews final approved departmental budgets prior to publication.
- Analyzes cost report settlement work papers for accuracy and follows up on discrepancies.
- Acts as liaison with the fiscal intermediaries for Medicare/Medicaid/NJ-DMAHS reimbursement matters. Representative for government payer audits responding to all requests and providing supporting documentation, as requested.
- Develops and maintains all Third Party Liability accounts. Prepares annual audit review document including all supporting documentation.
- Insures accuracy and timeliness of Medicare and Medicaid rate updates into the financial system.
- Interprets government reimbursement regulations and quantifies the impact of new regulations. Calculates impact of rate changes based on the final IPPS and OPPS Rule and incorporates results into revenue budget. Monitors IME/GME reimbursement and charity subsidy payments.
- In conjunction with General Accounting, conducts monthly post AP close expense reviews by department. Identifies expense accruals and seeks explanations from departments for major variances.
- Oversees the preparation of mandatory monthly and quarterly survey filings to outside agencies. Reviews surveys prior to submission.
- Prepares and reviews all Third Party reimbursement reports for accuracy and completeness, including but not limited to; Medicare/Medicaid cost report, IRIS GME/IME FTE Report, NJ Acute Care Hospital cost report, DSH Examination, Occupational Mix Survey, Tricare CAP/DME Reimbursement Request. Researches and identifies opportunities for maximizing reimbursement where appropriate.
- Reviews monthly statistical reports for accuracy and prepares volume variance explanations. Organizes monthly Medical Center financial package for internal review with Senior Vice President and Chief Financial Officer.
Bachelor’s Accounting Required
Additional Educational Requirements
Bachelor’s degree in Accounting or related field required.
5 Years of Healthcare Budget And Reimbursement Preferred
Supervisory Experience Preferred
Required Knowledge and Skills:
Knowledge of federal and state reimbursement procedures required. Strong professional, organizational, and interpersonal skills to effectively relate with all members of the healthcare team.
Normal office environment with occasional visits to locations across the System and off-site.
No expected exposure to blood and/or body fluids.
Sitting – Frequently
Standing/Walking – Rarely
Kneeling/Stooping – Rarely
Bending/Climbing – Rarely
Reaching above shoulder, at waist or below waist – Rarely
Lifting/Pushing or Pulling up to 40 pounds – Rarely
Lifting/Pushing or Pulling over 40 pounds – Not at all
Typing/Filing – Frequently
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
CentraState Healthcare System prohibits discrimination based on arbitrary consideration of such characteristics such as race, color, religion, national origin, ancestry, gender (including pregnancy), affectual or sexual orientation, gender identity or expression, marital status, age, physical or mental disability or limitation, medical condition, genetic information, or veteran or military status, as well as any other legally protected class of persons and acts, in accordance with applicable State and Federal laws.