Manager, Reimbursement and Cost Reporting

Hackensack Meridian Health; Woodbridge Township (NJ); On-site; USD 120,000 - 150,000; Full time

Job summary

Hackensack Meridian Health is seeking a Manager, Reimbursement and Cost Reporting to lead Medicare/NJ Acute Care cost reports, manage complex reimbursement studies, and supervise staff across a regional network. You will coordinate audits, model regulatory impacts, and develop strategies for appeals and DSRIP programs.

The role requires a Bachelor's in Accounting/Finance with 4+ years in reimbursement within a large health system, plus advanced Excel, Axiom, and PeopleSoft experience.

Qualifications

• Bachelor's degree in Accounting/Finance.
• Four or more years of progressive reimbursement related experience in a large health network and/or academic medical center.
• Advanced proficiency in using technology that includes Microsoft Office (Excel, Outlook, etc.), Axiom and PeopleSoft Financials System

Responsibilities

• Coordinates and oversees the accurate and timely completion of the Medicare and NJ Acute Care Hospital cost reports while also providing assistance to the team.
• Directs the preparation of the GME IRS filing.
• Develops the third party governmental appeal strategies and initiatives. Tracks success of re-openings and appeals.
• Coordinate, analyze and communicate an assigned topic/issue on a Network-wide basis to include, but not limited to: Appeal and Re-opening Management; Charity Care & GME Subsidies; Third Party Roll Forward Analyses; DSRIP Programs; and/or Wage Index modelling.
• Acts as a champion for DSRIP programs by educating key stakeholders, monitoring success, and identifying opportunities for improvement. Coordinates assembly of the Medicaid DSH Surveys while also providing assistance to the team.
• Maintains and organizes the supporting work paper documentation for the manager/director reviews. Final work papers used for all cost reports and DSH Surveys should be printed and maintained for historical reference.
• Facilitates the cost report process by creating worksheets, identifying data sources and gathering departmental information as needed. This includes developing new processes, worksheets or information requirements as necessary. Effectively communicates requirements, verbally and in writing, with various departments to ensure timely and accurate data collection.
• Coordinate Medicare/Medicaid audits with the CMS Intermediary as well as any audits for the NJACH cost reports while acting as a liaison between the hospital and the in-charge auditor. In addition, reviews proposed audit adjustments and communication with the auditor and manager regarding any questions or concerns relating to the adjustments proposed.
• Provides the coordination of the department's role in off-site reviews and moves by completing the necessary CMS 855's and State required financial information required by Federal and State agencies on a timely basis.
• Researches via the internet (MediRegs), relevant publications and/or manuals, various reimbursement compliance issues and strategies. Studies new regulations as they emerge and seeks out relevant research.
• Provides support in the supervision, coordination and education of the staff particularly during peak reporting periods.
• Ensures appropriate reports are downloaded and information obtained relating to outliers and third party reports. Researches variances until resolved.
• Completes all other necessary duties with attention to detail and in a timely manner including the Wage Index, Occupational Mix Survey and other relevant financial analysis relating to reimbursement issues as requested.
• Maintains high integrity work papers in a paperless business intelligence work environment.
• Assists the Budget Teams with various analyses and tasks when requested.
• Other duties and/or projects as assigned.
• Adheres to HMH's Managerial competencies and standards of behavior.

Education

Bachelor's degree in Accounting/Finance

Tools

Microsoft Office (Excel, Outlook)

Axiom

PeopleSoft Financials System

Job description

Overview

Our team members are the heart of what makes us better.

At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

The Manager, Reimbursement and Cost Reporting is responsible for providing support in the preparation of cost reports, reimbursement compliance and research, reimbursement studies and other related financial analysis for the Hackensack Meridian Health (HMH) network. Some responsibilities include the preparation of advanced sections of the Medicare and NJDOH cost reports, completion of advanced reimbursement studies and models (PPS Rate calculations, IME/GME, APC Rate calculations, etc.), audit coordination and support staff supervision and training. Also responsible for Monthly Medicare reconciliation and assists in completion of monthly third party review. Will have Network responsibilities for coordination and execution of reimbursement analysis, strategic modeling, appeal development and execution, regulatory research and summation, managing third party auditors and big data analytics. Also has oversite responsibility for the completion of cost reports for a dedicated region.

Responsibilities

• Coordinates and oversees the accurate and timely completion of the Medicare and NJ Acute Care Hospital cost reports while also providing assistance to the team.
• Directs the preparation of the GME IRS filing.
• Develops the third party governmental appeal strategies and initiatives. Tracks success of re-openings and appeals.
• Coordinate, analyze and communicate an assigned topic/issue on a Network-wide basis to include, but not limited to: Appeal and Re-opening Management; Charity Care & GME Subsidies; Third Party Roll Forward Analyses; DSRIP Programs; and/or Wage Index modelling.
• Acts as a champion for DSRIP programs by educating key stakeholders, monitoring success, and identifying opportunities for improvement. Coordinates assembly of the Medicaid DSH Surveys while also providing assistance to the team.
• Maintains and organizes the supporting work paper documentation for the manager/director reviews. Final work papers used for all cost reports and DSH Surveys should be printed and maintained for historical reference.
• Facilitates the cost report process by creating worksheets, identifying data sources and gathering departmental information as needed. This includes developing new processes, worksheets or information requirements as necessary. Effectively communicates requirements, verbally and in writing, with various departments to ensure timely and accurate data collection.
• Coordinate Medicare/Medicaid audits with the CMS Intermediary as well as any audits for the NJACH cost reports while acting as a liaison between the hospital and the in-charge auditor. In addition, reviews proposed audit adjustments and communication with the auditor and manager regarding any questions or concerns relating to the adjustments proposed.
• Provides the coordination of the department's role in off-site reviews and moves by completing the necessary CMS 855's and State required financial information required by Federal and State agencies on a timely basis.
• Researches via the internet (MediRegs), relevant publications and/or manuals, various reimbursement compliance issues and strategies. Studies new regulations as they emerge and seeks out relevant research.
• Provides support in the supervision, coordination and education of the staff particularly during peak reporting periods.
• Ensures appropriate reports are downloaded and information obtained relating to outliers and third party reports. Researches variances until resolved.
• Completes all other necessary duties with attention to detail and in a timely manner including the Wage Index, Occupational Mix Survey and other relevant financial analysis relating to reimbursement issues as requested.
• 1Maintains high integrity work papers in a paperless business intelligence work environment.
• Assists the Budget Teams with various analyses and tasks when requested.
• Other duties and/or projects as assigned.
• Adheres to HMH's Managerial competencies and standards of behavior.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• Bachelor's degree in Accounting/Finance.
• Four or more years of progressive reimbursement related experience in a large health network and/or academic medical center.
• Advanced proficiency in using technology that includes but is not limited to Microsoft Office (Excel, Outlook, etc.), Axiom and PeopleSoft Financials System