MANAGER, REIMBURSEMENT & REVENUE INTEGRITY
SOUTHEAST GEORGIA HEALTH SYSTEM
BRUNSWICK, GA
HARTZ Search invites you to explore an exciting opportunity with our client, Southeast Georgia Health System, for the Manager of Reimbursement & Revenue Integrity reporting directly to the Executive Director, Reimbursement & Decision Support. The Manager, Reimbursement & Revenue Integrity will be responsible for the development, implementation, and continual refinement of Health Systems charge structure, revenue integrity, price transparency, and managed care reimbursement strategies. This position will provide the technical and analytic support required for the Health System’s Managed Care contracting and Reimbursement activities.
All team members of Southeast Georgia Health System will promote a culture of safety, follow established policies, and adhere to all state and federal regulatory requirements, Joint Commission requirements, and national patient safety standards.
Responsibilities:
- Completes the prospective modeling of proposed contracts, scenarios, and other changes potentially impacting reimbursement to support day to day operations and contract negotiations.
- Responsible for accurately loading and maintaining all fee schedules and contract terms in the Axiom Contract Management System. Thoroughly tests and validates loaded contracts to effectively maximize both patient care and revenue cycle needs.
- Provides analytic support to determine the financial impact of changes in rates and regulations for both Government and commercial payers including developing “what if” scenarios to support managed care contract negotiations.
- Maintains CMS Medicare / Pecos system and credentialing records for the Health System Hospitals, including off-site departments and Senior Care Centers. Tracks the status of GA Medicaid and CMS Medicare enrollment in PECOS.
- Assists in Cost Report preparation and reimbursement impact analysis.
- Supports Price Transparency maintenance and participates in data analysis for Charge Master.
- Assists with the preparation of the Health System Revenue Budget.
- Participates as needed on various organizational steering committees to provide guidance on changes that impact Reimbursement and the CDM.
Education:
- Bachelor’s Degree in either Accounting, Business Administration, or Financial Management
Experience:
- Min-5 years’ progressive experience in a healthcare environment with emphasis on Managed care reporting and Reimbursement. Experience in Axiom Contract Management tool Preferred.
- General understanding of DRG and CPT/ HCPC codes as well as Government reimbursement methodologies.
- General knowledge of hospital Revenue cycle functions.
- Ability to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations.
- Computer literate with general ledger systems and Microsoft Office Suite, with advanced Excel skills including pivot tables and VLOOKUP.
Position Highlights:
- The Manager, Reimbursement & Revenue Integrity, will report directly to the Executive Director, Reimbursement & Decision.
- Competitive compensation and benefits package offered.
LOCATION – BRUNSWICK, GEORGIA:
Brunswick is a city on the southeast coast of Georgia. It’s known for its Victorian-era Old Town Historic District and the huge, centuries-old Lover’s Oak tree. Causeways link the city to the 4 barrier islands of the Golden Isles. Sea Island has resorts and golf clubs. St. Simons Island is home to Fort Frederica National Monument, the preserved remains of an 18th-century stronghold, and the St. Simons Lighthouse Museum.
INTERESTED CANDIDATES, PLEASE APPLY DIRECTLY to HARTZ Search below:
Qualified candidates, please submit your current resume - applications will not be considered without a resume. Thank you!
Application Link: https://hartzsearch.com/open-position/manager-reimbursement-revenue-integrity/
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