Director, Reimbursement (Job Number: 13373)

Schedule: Full-time | Shift: Day Shift

Job Summary
This role will support the Health system CFO in overseeing the reimbursement functions for the health system. Must demonstrate a working knowledge of reimbursement rules and negotiations for modeling multiple scenarios and advising senior leadership on how to optimize reimbursement. Must stay abreast of current Medicare / Medicaid regulation changes and incorporate those into the Cost Reporting as well as other payor issues. Responsible for taking the lead with departments regarding reimbursement related issues. Responsible for analyzing the impact of any changes in reimbursement regulations for Phoebe Putney Health System. Directs the preparation of documentation and worksheets to support the completion of the Medicare and Medicaid Cost Reports. Experience in various complex reimbursement areas such as Medicare and Medicaid cost report preparation, DSH, PIP, wage index analysis, audits and appeals, provider enrollment/provider-based attestations, graduate medical education, Georgia ICTF-UPL programs. All activities will be performed in support of the strategy, vision, and values of Phoebe. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA, and other regulations, as appropriate.

General requirements

• Performs all job responsibilities in alignment with the core values, mission and vision of the organization
• Performs other duties as required and completes all job functions as per departmental policies and procedures
• Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs)
• Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
• Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills.
• Adheres to the hospital and departmental attendance and punctuality guidelines
• Knowledgeable in Cost Reporting Software, Understanding of Hospital Reimbursement

Working Conditions

• General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.
• May be exposed to limited hazardous substances or body fluids, or infectious organisms.
• May be required to change from one task to another of different nature without loss of efficiency or composure.
• Periods of high stress and fluctuating workloads may occur.