Reimbursement Manager

Shift: Day
Schedule: Full - Time Regular

Ardent Health Services invests in people, technology, facilities and communities, producing high-quality care and extraordinary results. Based in Nashville, Tennessee, Ardent’s subsidiaries own and operate 31 hospitals in seven states with more than 25,000 employees including 1,150 employed providers. Ardent facilities exceed national averages in Overall Hospital Quality Star Rating as ranked by the Centers for Medicare & Medicaid Services; 89 percent of its hospitals received a three-star rating or above in comparison with 73 percent of all hospitals ranked. Five of the company's hospitals were recognized by Modern Healthcare as "Best Places to Work" in 2018 - the eleventh consecutive year an Ardent facility made this list. Ardent's corporate office was named "Top Work Places" for Nashville based companies in 2017 and 2018.

We have an exciting opportunity to join our team as a Reimbursement Manager.

The Reimbursement Manager obtains proper Medicare, Medicaid and other third-party cost based reimbursements for assigned hospitals and ensures hospital compliance with Ardent's standard third-party accounting system.

PRIMARY RESPONSIBILITIES

  • Prepares annual Medicare, Medicaid and other third-party cost reports in compliance with rules and regulations of the respective third-party program.
  • Defends filed cost report, as appropriate, during the annual cost report audit.
  • Protects appeal rights for cost report audit adjustment(s) by ensuring compliance with required administrative appeal procedures and provides support during the appeal process.
  • Provides support to assigned hospitals for calculation of monthly contractual adjustments.  Reviews such calculations for accuracy and propriety.
  • Monitors interim Medicare payments to assigned hospitals to ensure that such payments reflect estimated cost-based reimbursement for the respective accounting period.
  • Monitors local hospital compliance with Ardent’s standard third-party accounting system.
  • Maintains appropriate level of expertise in the area of Medicare and Medicaid reimbursement. 
  • Monitors regulatory changes in such programs and assists in maintaining Ardent’s compliance with such program rules and regulations.
  • Works with external auditors in their conduct of interim and annual financial audit activities.
  • Supports hospital acquisition activities by actively participating in the due diligence process via evaluation of third-party reimbursement issues related to the acquisition candidate.
  • Assists in preparing annual hospital operations budget for contractual adjustments.
  • Provides decision support to operations management to evaluate hospital operations to achieve optimum financial results.
  • Develops and maintains good working relationships with Intermediaries / governmental agencies.
  • Develops and maintains good working relationships with Ardent Corporate, Group, and local hospital personnel.
  • Assists in review of work performed by Ardent’s Reimbursement staff.
  • Performs other duties as assigned.

QUALIFICATIONS

Education and Work Experience:

  • BBA or BS in Accounting, Finance or Business
  • 3+ years of reimbursement experience
  • Demonstrated ability to quickly learn and utilize various financial systems
  • Desire to automate processes using software

Additional Requirements:

  • Advanced skill set in Microsoft Excel
  • Enjoys supporting end users
  • Great attention to details
  • Problem solving skills
  • Action-orientated with the ability to meet deadlines and turnaround requests in short order
  • Needs to be comfortable with a small and fast-paced environment
  • Must have a high sense of urgency, be good at multi-tasking, a self-starter and be comfortable with adapting to change

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.