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Mount Sinai Health System · 1 day ago

Associate Director Reimbursement-Financial Analysis Reimbursement-Corporate 42nd Street-Full-Time-Days

New York, NY

Full-time

Onsite

Senior Level, Lead/Staff

$80K/yr - $120K/yr

3+ years exp

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, and they are seeking an Associate Director of Reimbursement-Financial Analysis to ensure maximization of reimbursement for their facilities. The role involves preparing and analyzing financial reports, training staff, and ensuring compliance with reimbursement regulations.

Health CareHospitalMedical

Responsibilities

Reviews all rate calculations received from various Third Party Payers, ensuring the accuracy of data

Prepares appeals to various Third Party Payers, stating the Institutions position on proposed changes to the reimbursement regulations

Analyzes and maintains the monthly activity for the Blue Cross Medicare and Medicaid rate accounts/suspense accounts

Analyzes the monthly activity and prepares schedules for the Bad Debt and Charity Care Pool accounts, recording and reviewing all payments and distributions made to and from the Pools

Develops charges for various inpatient and outpatient services for the two Institutions, gathering all the cost information involved with the service and ensure that the developed charge is comparable to other Health Care Institutions

Prepares cash budget for the department

Trains and assigns work of staff

Responsible for updating department with all new regulations and proposed changes to the Medicare Reimbursement System, as set forth in the Health Care Financial Administration Publication 15-1, the Federal Register, and Part 86-1 of the Health’s Rules and Regulations

Interfaces with auditors from fiscal intermediary and independent accounting firm to ensure the proper presentation of the facilities Revenues and Expenses and balance sheet items in the annual financial statements and Institutional Cost Report

Qualification

Reimbursement RegulationsInstitutional Cost ReportHealth Care AdministrationFinancial AnalysisPublic AccountingInterpersonal Skills

Required

Bachelor degree in Health Care Administration, Finance or Accounting. Applicable work experience may be considered in lieu of educational requirements

Approximately three to four years of progressively more responsible related work in a health care institution, fiscal intermediary, or Public Accounting Firm involved in health care auditing

Thorough knowledge of Reimbursement Regulations and principles as set forth in the Health Care Financial Administration Publication 15-1, the Federal Register, and Part 86-1 of the Commissioner of Health's Rules and Regulations

In-depth knowledge of the Institutional Cost Report, the Blue Cross Supplement and New York State Supplement, the Provider and Provider Based physician questionnaires, the prospective payment system and case payment system

Interpersonal skills necessary to direct activities of subordination personnel and to deal effectively with various Hospital departments, outside auditors and agencies and other health care providers