Manager, Enterprise Reimbursement

WVU Medicine

Introduction:

WVU Medicine is West Virginia’s leading provider of advanced medical and surgical care. Employees exhibit knowledge, commitment, compassion, and excellence. We offer competitive pay and benefits because we want to attract and keep the best employees who will share our commitment to the highest quality patient care. Pursuing a career at WVU Medicine means you have access to many challenging and rewarding opportunities in clinical and non-clinical areas.

This position is responsible for ensuring that all WVUHS hospitals are in compliance with all state and federal regulatory reporting requirements relating to reimbursement. Extensive knowledge of third party reimbursement regulations is required. This position is also responsible for managing net revenue, development of budget, reserve analysis and identifying and implementing revenue enhancement opportunities

Job Description:

Core duties and responsibilities: 

1. Ensures that all Hospitals are in compliance with all state and federal regulations related to reimbursement
2. Manages the preparation and analytical review of all external Medicare Cost Reports, WV HCA filings and all other state or federal reimbursement filings for all hospitals
3. Reviews and analyzes all state and federal reimbursement regulations to ensure compliance and presents financial impact of changes in regulations
4. Communicates directly with external auditors, third party payors and WV HCA staff in regard to financial matters.
5. Coordinates the development of the net revenue budget
6. Establishes a process for ongoing monitoring of gross and net revenue, including an analysis of reserves for contractual, bad debt and charity
7. Coordinates with patient financial services and accounting the processing of changes in third party payment requirements and the impact on financial reporting and financial statements
8. Ensures that the financial terms of managed care contracts are thoroughly and accurately analyzed and monitored
9. Ensures that the long range financial planning process includes accurate and up to date reimbursement assumptions
10. Coordinates projects related to revenue enhancement opportunities
11. Works with legal counsel and the fiscal intermediary to identify and resolve outstanding Medicare appeal issues.
12. Develops and maintains an ongoing staff development program and an orientation program for the reimbursement staff
13. Consistently monitors and documents performance of staff members and utilizes appropriate reward and disciplinary measures as needed
14. Demonstrates an ability to create an atmosphere that fosters motivation of staff to work at optimal efficiency and encourages staff to regularly establish and achieve departmental goals
15. Provides leadership and direction to professional staff and maintains a professional working relationship with all staff, always responds to staff concerns in a professional and timely manner; maintains appropriate interdepartmental communication

Required Qualifications:

Bachelor’s Degree in Business with a major in Accounting or Finance
Five (5) years of experience in healthcare finance or accounting

Preferred Qualifications:

MBA or CPA

Compensation/Benefits:

  • Competitive Salary: As the largest employer in West Virginia, we want to be a leader in the state and region when it comes to pay and benefits
  • Medical, Dental and Vision Insurance
  • PTO
  • 403-B Savings Program
  • Tuition Reimbursement Programs

Instructions for Resume Submission:

If interested please apply at https://re12.ultipro.com/WES1019WVUH/JobBoard/JobDetails.aspx?__ID=*2DB2AE5688474CBE