Manager, Reimbursement in Brentwood, TN at Health Support Center

Date Posted: 5/13/2021

Job Snapshot

Job Description

LifePoint Health- Health Support Center

The Manager, Reimbursement manages and files Medicare and Medicaid cost reports and other regulatory reporting requirements, working with Centers for Medicare and Medicaid Services (CMS) and Medicaid States Agencies during the audit of these cost reports, and for forecasting Medicaid supplemental payment income, etc. 

ESSENTIAL FUNCTIONS:  To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation. 

  • Collaborate with hospitals to ensure Medicare and Medicaid contractual accruals and settlement estimates are accurate.
  • Monitor state legislative activity to ensure Lifepoint is aware of upcoming Medicaid payment changes or opportunities to influence policy. 
  • File Medicaid Disproportionate Share Hospital (DSH) audits, month end close related to governmental payers, and other miscellaneous activities for their assigned hospitals. 
  • Mitigate risk of loss of income and seize opportunities to provide value throughout the reimbursement process related to Medicare and Medicaid programs to include, but not limited to, the planning, filing, and auditing of Medicare and Medicaid cost reports. 
  • Review monthly Governmental exhibits as a part of month end close and complete/file annual Medicare and Medicaid Cost Reports. 
  • Review exhibit models and assist in the calculation of net revenue, represent the hospital during audit, review the assigned hospitals month end exhibits, and complete a detailed review once a quarter.
  • Work with Governmental Relations in monitoring Medicaid legislative changes for assigned States.
  • Review monthly and quarterly Government reimbursement exhibits to ensure cash and accrued reimbursement rates are properly set.
  • Adjust accruals and reimbursement factors as needed, in conjunction with Federal and State guidance, as well as with internal costing data.
  • Process month end close to include calculating, reviewing, and preparing entries related to state supplemental payment programs.
  • Regular and reliable attendance.
  • Perform other duties as assigned.

Additional Information:

  • Serves both internal co-workers and external customers, clients, patients, contractors, and vendors.
  • Access to and/or works with sensitive and/or confidential information.
  • Exhibit an understanding of healthcare regulatory and compliance (e.g., HIPAA).  Skilled in the application of policies and procedures. Knowledge of Business Office Standards and Recommended Practices.

Job Requirements

KNOWLEDGE, SKILLS & ABILITIES: The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education: Bachelor's Degree in Accounting.

Experience: Minimum of 5 years related experience in hospital reimbursements.

Certifications: Certified Professional Accountant (CPA) preferred

Licenses: N/A

Skills and Abilities:

  • Business Mathematical Skills -- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rates, ratios, and percentages and to draw and interpret graphs.
  • Moderate Computer Skills -- Frequent use of electronic mail, word processing, data entry, spreadsheets, graphics, etc. Ability to create, maintain and incorporate simple functions into documents, spreadsheets, databases, and presentations to support business objectives.
  • Complex Communication -- Frequently communicates complex information and interacts with management. Can present, resolve, and address delicate situations. Can motivate and persuade others.
  • Varied Business Problems -- Problems are varied and complex, requiring analysis or interpretation of the situation. Problems are solved using knowledge and skills, general precedent and practices.
  • Department Specific -- Decisions impact the management and operations within a department. May contribute to business and operational decisions that affect the department.
  • Functional Independent Judgement -- Provides and sets goals and priorities for functional area. May make recommendations for department policies, practices, and programs. Makes decisions for and/or resolves problems for others.
  • Project Planning/Organization -- Handle multiple projects simultaneously including task delegation, project oversight, and resource allocation.

PHYSICAL AND MENTAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit for extended periods of time; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, bend, crouch or crawl; talk or hear; taste or smell.  The employee must occasionally lift and/or move up to 20 pounds.  Repetitive motion of upper body required for extended use of computer. Required specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK ENVIRONMENT AND TRAVEL REQUIREMENTS:

Work environment characteristics described here are representative of those that an employee may encounter while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

Works in well-lit, ventilated and climate controlled office environment with routine office equipment; some equipment has moving mechanical parts.

In hospital environment, may be exposed to hazards and unusual elements, which may include but are not limited to bloodborne pathogens and / or contagious illnesses, toxic chemicals, and biohazardous materials which may require extensive safety precautions and the use of protective equipment.

Noise level in the work environment is typical for an office and/or hospital environment.

Minimum overnight travel (up to 10%) by land and/or air.


LifePoint Health is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans’ status or any other basis protected by applicable federal, state or local law.

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