Director of Reimbursement

  • Carolinas Healthcare System
  • Charlotte, NC, USA
  • Jun 21, 2017
Full time

Job Description

Location Details: 
Carolinas HealthCare System is Atrium Health. Our mission remains the same: to improve health, elevate hope and advance healing - for all. The name Atrium Health allows us to grow beyond our current walls and geographical borders to impact as many lives as possible and deliver solutions that help communities thrive. For more information, please visit
Job Summary
This role supports the AVP Reimbursement in overseeing the reimbursement functions for Carolinas HealthCare System.  Must demonstrate a comprehensive knowledge of reimbursement rules and negotiations for modelling multiple scenarios and advising senior leadership on hot to optimize reimbursement at both the State and Federal level.  Requires experience in various complex reimbursement areas including, but not limited to, Medicare and Medicaid cost report preparation, audits and appeals, provider enrollment/provider-based attestations, DSH, wage index analysis, graduate medical education, and transplant/organ acquisition reimbursement.

Essential Functions
  • Ensures the completeness and accuracy of the departmental segment of the financial statements, annual budgets and reports prepared for internal and external use.
  • Oversees the daily operations of the departments specific accounting function and plans departmental workload.
  • Reviews and approves journal entries and account reconciliations and ensures such are prepared on a timely basis.
  • Ensures the System's records and financial statements are maintained in accordance with generally accepted accounting principles.
  • Prepares work papers for annual audit, serving as liaison with external auditors as related to their departments. Delivers all required statutory filings in a timely manner.
  • Ensures compliance with requisite document retention requirements.
  • Manages the maintenance of departmental procedures and System policy manuals and recommends improvements. Coordinates changes with leadership.
  • Monitors workload and methodologies used to achieve results, making recommendations to improve efficiency and/or achieve cost savings whenever possible.
  • Must have an understanding of complex Medicare/Medicaid reimbursement including:
    • Interns & Residents, Nursing & Allied Health, Medicare bad debts, DSH, UCC, transplant, organ acquisition
    • Various payment methodologies: IPPS, OPPS, IPS, IRF, SNF, LTCH, MDH, SCH, etc.
    • Cost report preparation
    • Provider based regulations and preparing provider based attestations
    • Ability to research applicable Medicare/Medicaid laws and regulations
  • Experience modeling various reimbursement scenarios and opportunities
  • Experience with wage index reviews including identifying opportunities to optimize wage index
  • Experience with cost report audits and appeals including preparation of supporting documentation and identification of appeal opportunities
Physical Requirements
Lifting and moving reports and notebooks weighing up to 10 pounds. Ability to work under pressure and meet deadlines. Majority of day is spent sitting.

Education, Experience and Certifications
Bachelors Degree required; Accounting or Finance preferred. Masters Degree in Business Administration preferred. CPA preferred. Minimum 6 years experience as a hands-on financial manager preferred.

At Carolinas HealthCare System, our patients, communities and teammates are at the center of everything we do. Our commitment to diversity and inclusion allows us to deliver care that is superior in quality and compassion across our network of more than 900 care locations.
As a leading, innovative health system, we promote an environment where differences are valued and integrated into our workforce. Our culture of inclusion and cultural competence allows us to achieve our goals and deliver the best possible experience to patients and the communities we serve.
Posting Notes: Not Applicable
Carolinas HealthCare System is an EOE/AA Employer