Director - Government Reimbursement Job at Piedmont Healthcare Inc., Atlanta, GA

RkQzWFZyMGg2WTJEV3B3aDg3OUVnaHFYM0E9PQ==
  • Piedmont Healthcare Inc.
  • Atlanta, GA

Job Description

Overview:

Experience the advantages of real career change

Join Piedmont to move your career in the right direction. Stay for the diverse teams you’ll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You’ll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future. 

Responsibilities:

Organizing, coordinating, and performing the reimbursement function for Piedmont Healthcare and system entities, including the preparation of entity Medicare/Medicaid/ Tricare cost reports, surveys, audits, appeals, budget and planning in an effort to assist management in operational and compliance decisions. This position reports to the Piedmont Healthcare Government Reimbursement Executive Director.

 

KEY RESPONSIBILITIES:

1. Prepares and files Piedmont Healthcare Medicare/Medicaid/Tricare Cost Reports by applicable federal and state deadlines.

2. Prepares and maintains all schedules and analysis supporting cost report preparation.

3. Coordinates Medicare and Medicaid audits and prepares all supporting work papers and documentation.

4. Analyzes Medicare Administrative Contractor (MAC) correspondence and interim rate setting to ensure accurate reimbursement and compliance with regulations.

5. Works with senior management to research, analyze, and communicate reimbursement issues.

6. Prepares pro-formas with regard to third party reimbursement.

7. Monitors regulatory changes for compliance and also seeks ways to optimize reimbursement.

8. Assists Piedmont Healthcare and system entities with reimbursement percentages for use in calculating contractual reserves. Provides the Government Reimbursement Executive Director with research and ad hoc reporting, as directed.

9. Provides documentation for use in calculating monthly reserve requirements for Piedmont Healthcare and system entities.

10. Prepares and assists Piedmont Healthcare and system entities with Medicare, Medicaid, and state surveys.

11. Reviews and analyzes Medicare and Medicaid Remittance Advices to ensure proper payments.

12. Ensures all third- party pass thru payments and lump sum adjustments are received as communicated by the Medicare Administrative Contractor (MAC) and account.

13. Reviews cost report settlements for accuracy and compliance with regulations.

14. Review cost report settlements and assists with appeal filings, where applicable.

15. Coordinates cost report reopening reviews and prepares all supporting documentation.

16. Assists with graduate medical education reporting for Piedmont teaching facilities.

17. Assists with the completion and timely submission of the Interns and Residents Information System (IRIS) software program to Medicare.

18. Prepares the Allied Health reporting and reimbursement for cost report filing.

19. Prepares the Wage Index and Occupational Mix Survey filings and reviews.

Qualifications:

Education

  • Bachelor’s Degree in Accounting or a related field Required
  • Master’s degree in Accounting or a related field Preferred

Work Experience

  • 7 years of government healthcare reimbursement and accounting experience Required
  • Experience with CMS PRM regulation manuals, the CMS 2552 software system, and the CMS IACS/ EIDM system Required

Licenses and Certifications

  • None Required
  • Certified Public Accountant (CPA) Preferred
Business Unit : Company Name: Piedmont Healthcare Corporate

Job Tags

Full time, For contractors, Work experience placement, Interim role

Similar Jobs

Grass Pad, Inc.

Garden Center Cashier Job at Grass Pad, Inc.

 ...Job Title: Garden Center Cashier Location: Omaha Status: Part-Time, Full-Time, Hourly, Daytime and Some Weekend Availability Reporting Relationship: Store Manager Work Schedule: Hours vary by season. The Grass Pad is hiring Part-Time and Day-Time Cashiers... 

Whole Foods Market

Butcher - Full Time Job at Whole Foods Market

 ...Performs duties relating to the cutting, preparation, display, and selling of meat products. All Whole Foods Market Retail jobs require ensuring a positive company image by providing courteous, friendly, and efficient service to customers and Team Members at all times... 

Skilled Trades Services

Pipe Welder Job at Skilled Trades Services

Skilled Trades Services is currently looking for Pipe Welders for Muscatine, IA area. Must be able to start ASAP. Must have 5 years of...  ...30 an hour with $100 a day per diem for days worked if you are traveling over 50 miles. MUST BE ABLE TO PASS A 10 PANEL DRUG SCREEN,... 

Yardscapes Inc

Landscape Project Manager Job at Yardscapes Inc

 ...Yardscapes Inc is looking to add an Additional Project Manager to our team. We are a 52-year-old company that services high-end projects...  ...round ,salary with benefits. You must have knowledge of: Landscape construction: Hardscapes Masonry Swimming Pools... 

Ansible Government Solutions

Remote Medical Support Assistant (Remote Medical Receptionist) Job at Ansible Government Solutions

 ...Overview Ansible Government Solutions, LLC (Ansible) is currently recruiting Remote Medical Support Assistants(Remote Medical Receptionists) that is to support the Washington VA Healthcare System. Working hours are Mon-Fri, 7am-6pm (8-hour shifts within this window...