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Baptist Memorial Health Care · 1 day ago

Consultant-Reimbursement-PRN

Memphis, TN

Full-time

Onsite

Senior Level, Lead/Staff

10+ years exp

Baptist Memorial Health Care is a healthcare organization seeking a Consultant-Reimbursement to assist the Director with cost reporting and audit support. The role involves ensuring accurate patient registration, compliance with financial guidelines, and overseeing reimbursement reporting processes.

GovernmentHealth CareHospitalMedicalNon ProfitNursing and Residential CareRehabilitationWellness

Responsibilities

Registers patients accurately, efficiently and professionally to ensure data base integrity and facilitate claims processing

Applies financial screening guidelines to ensure proper procedures are followed in obtaining upfront collections for the specific facility

Strives to expedite patient flow through prompt and courteous service

Completes assigned goals

Performs other duties as assigned, to include health screening

Assists in compliant reimbursement reporting and optimal revenue achievement from cost reports and modeling from regulations

Helps oversee filing of annual Medicare, Medicaid (including Tennessee Joint Annual Report), and Tricare cost reports along with all audits, surveys, and appeals related to such reports

Tracks cost report process to ensure compliant, accurate, and timely reporting of such reports

Assist in maintenance of 3rd party balance sheet accounts for all entities with costs reporting generated settlements, are maintained and calculates/recommends reserves as needed

Assists Sr. Appeal Manager in the reviews appeals and reopening's requested so as to determine cost/benefit analysis of pursuing with regard to the identified issues

Reviews year-end estimates and all supporting calculations for consistency with each hospital's services

Works with system outside consultants, contractors, and attorneys as needed to support system's hospital government reimbursement activities

Provides guidance to Senior Leadership regarding compliance with new laws/regulations as applied to government reporting requirements

Ensures hospital E.H.R./Meaningful Use attestations are filed timely and provides all documentation needed for hospital MU audits

Serves on association reimbursement-related committees

Reviews rate changes, both facility specific and government published global, for correct contractual calculations within the patient accounting system

Oversees preparation of annual State supplemental & DSH surveys/audits

Evaluates medical education reimbursement information working closely with Chief Academic Officer and Medical Education Staff

Performs other duties assigned

Qualification

Government reimbursement reportingFinance leadershipCost reportingCPAMulti-hospital experienceAnalytic skillsCollaborative relationshipsInterpersonal skillsOrganizational skills

Required

BS in Finance, Business or related field

10 plus years finance leadership with solid background of government reimbursement reporting processes

Experience in multi-hospital healthcare system

Abilities to foster collaborative relationships with key stakeholders

Comprehensive knowledge of all government reimbursement-related regulations including but not limited to Medicare, Medicaid, and Tricare

This includes knowledge of Medicare and Medicaid medical education, transplant, allied health, CAH, 340b, and all other related areas

Must possess strong interpersonal, analytic and organization skills with demonstrated experience leading, managing deadline driven projects, and teams in a fast paced environment