The DUHS Reimbursement department is responsible for planning, developing, coordinating and preparing financial analysis and reporting for net patient revenue and reimbursement to support:
- AR valuation and month-end close
- Patient data and related modeling in the cost accounting system
- Managed Care contract proposals and negotiations
- Margin improvement initiatives
- Cost report submissions and audits
- Operational budgets and forecasts
- Financial plans and CON applications
The department performs complex and specialized assignments utilizing reimbursement expertise. This position reports to the Director of Cost & Revenue Accounting. This position frequently interacts with Entity Finance analysts, IT personnel, department managers, and PRMO staff.
Duties & Responsibilities
- Plan, develop, coordinate and prepare financial analysis and reporting for net patient revenue to support AR valuation / month-end close. Create ad hoc reports as needed for business questions that arise regarding gross revenue and/or modeled revenue.
- Audit, upload and post patient data into EPSi on a monthly basis; ensure all data tables needed for reimbursement modeling are loaded and updated on a regular basis. Reconcile EPSI patient data to the subledger and audit the transaction level and encounter level interfaces.
- Plan, develop, coordinate and prepare reimbursement analysis to support Managed Care contract proposals and negotiations.
- Prepare analysis and recommendations for margin improvement initiatives.
- Provide data and analysis to support the annual Cost Report submissions and audits.
- Plan, develop and assist in the creation of analytical reports and tools to support the net patient revenue budgets, forecasts, financial plans, surveys, and CON applications.
- Communicate via email distribution list any / all issues related to EPSi, such as the on-line availability, the processing schedule or data integrity issues.
- Hybrid work schedule with at least one day on-site weekly. Mandatory work on the first three days of the month, regardless of weekend or holiday.
- May involve off-site travel to hospitals within the Health System.
Key Work Style Attributes
- Ability to work under pressure, multi-task, adapt to changing priorities and produce quality work, while meeting deadlines
- Demonstrate ability to work independently with little guidance and demonstrate ability to handle and prioritize multiple assignments and overlapping deadlines
- Demonstrate initiative
- Attention to detail and accuracy are extremely important and highly valued
- Excellent oral, written and interpersonal skills mandatory
- Excellent organizational, analytical, and problem-solving skills mandatory
- Must be a team player with proven ability to interact well with all levels of management and staff
- A professional approach to work including a strong sense of responsibility for assigned duties
Minimum Qualifications
Education
Work requires a Bachelor's degree in Accounting, Finance, Economics, Business Administration, or a related field. CPA is preferred..
Experience
- Work requires a minimum of six years experience in financial management, cost accounting, or a field directly related to a specialized area of assignment.
- A minimum of six years experience in financial management, accounting or equivalent combination of education and experience
- Demonstrated understanding of hospital (inpatient and outpatient), physician, ambulatory surgical center and IDTF reimbursement methodologies
- Proficient in Microsoft Excel required; proficient in SQL preferred
Degrees, Licensures, Certifications
CPA Preferred
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