Reimbursement Services Director jobs in Wisconsin

Reimbursement Services Director directs and supervises the activities of the claims and provider reimbursement personnel. Handles third-party reimbursement for services rendered to patients. Being a Reimbursement Services Director sets procedures for filing reimbursement claims and ensures timely and accurate claims payments. Monitors, evaluates and reviews all cost reporting in support of reimbursement claims. Additionally, Reimbursement Services Director develops policies and procedures compliant with fiscal and regulatory requirements. Oversees the collection of statistical and financial data needed for preparing annual and monthly health insurance reports. May require an advanced degree. Typically reports to top management. The Reimbursement Services Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Reimbursement Services Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Director Reimbursement Analytics
  • Advocate Health
  • Allenton, WI FULL_TIME
  • Supports the Vice President, Reimbursement in all matters related to third-party accounting within the AAH service area. In addition, this position is to serve as a key liaison between the Reimbursement department and hospital financial leadership as well as governmental auditors and will be looked to as a departmental leader in technical issues related to the monthly financial close. Monitors proposed and final government reimbursement regulations and provides oversight in the development of the financial analysis around government and commercial reimbursement to determine the overall impact the changes have on the organization. Proposes changes to strategies to address the changes in reimbursement in order to maximize AAH’s reimbursement.

    • Oversees the completion of required monthly financial analyses for AAH hospitals to support the net revenue calculation and other reporting needs. This includes coordination and management of staff responsible for the calculation of the monthly financial statement calculations related to third-party reimbursement matters and ensuring consistency amongst all the AAH hospitals’ calculations and source data utilized.
    • Manages and maintains appropriate external relationships with the Fiscal Intermediary, IDPA, WDPA, Illinois/Wisconsin Hospital Associations and consultants engaged on behalf of Advocate Aurora as well as internal relationships with the Medical Education Department, SRCO, Payroll and General Accounting.
    • Assists departmental leadership with the valuation of required Medicare cost report reserves and Valuation Allowance accounts and assists in supporting the calculation with external financial auditors during year-end audit.
    • Acts as AAH’s finance representative in regards to matters which relate to third party reimbursement. This can include but is not limited to participating on State Hospital Association and State Medicaid task forces and internal councils, teams, panels, educational projects and steering committees.
    • Identify, research, and initiate opportunities to enhance revenue and improve administrative efficiency of governmental payer programs while ensuring internal Advocate Aurora policies are updated and all staff are aware of and following the applicable policy points.
    • Assists in the development and forecasting of systemwide revenue budgets. Ensures that budgeting for Gross and Net Patient Revenue is accurate, timely, and complies with accounting standards. Working with members from the revenue cycle and managed care operations, leads the analysis of budget variances on a monthly basis, including the preparation of the necessary analysis to document and explain the budget variance to leadership and finance.
    • Identify, research, and initiate opportunities to enhance revenue and improve administrative efficiency of governmental payer programs while ensuring internal Advocate Aurora policies are updated and all staff are aware of and following the applicable policy points.
    • Remains up to date on reimbursement matters impacting the calculation of AAH net patient revenue and be able to disseminate such information to the team in a clear and timely manner to allow consistent and correct calculations to be performed including issues related to FASB Revenue Recognition pronouncements.
    • Assists in the development of annual departmental budgets, monitors monthly performance to budget, and when necessary initiates actions to rectify variances.

    Scheduled Hours

    Corporate business hours. This position is primarily remote; willing to consider out of state candidates.

    Licenses & Certifications

    None Required.

    Degrees

    Bachelor's Degree in Accounting, or

    Bachelor's Degree in Finance or related field.

    Required Functional Experience

    Typically requires 7 years of experience in health care reimbursement or public accounting with a concentration in hospital auditing that includes extensive auditing of the hospital net patient service revenue area, Medicare, Medicaid, or Blue Cross.

    Required Management Experience

    Includes 3 years of management experience in managing staff and budgets.

    Knowledge, Skills & Abilities

    Ability to use Microsoft Office programs. Ability to use Medicare/Medicaid cost reporting software. Ability to use AAH’s general ledger, accounts payable, payroll, patient accounting, and decision support systems. Must possess strong analytical and accounting skills. Must possess detailed knowledge of various reimbursement methodologies such as DRG, per-diem, capitation and percent of charges. Must possess detailed knowledge of Medicare and Medicaid reimbursement rules as well as a detailed understanding of the Illinois Blue Cross UPP system and Graduate Medical Education, Disproportionate Care, Transplant programs, and 340B issues. Must possess the ability to work independently and under stressful conditions. Must be able to work weekends during peak cost reporting times, budget season and during year-end audit. Must possess strong communication and interpersonal skills and the ability to communicate revenue cycle issues to all levels of the organization.
  • 8 Days Ago

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Director Reimbursement Analytics
  • Advocate Aurora
  • Allenton, WI FULL_TIME
  • Supports the Vice President, Reimbursement in all matters related to third-party accounting within the AAH service area. In addition, this position is to serve as a key liaison between the Reimburseme...
  • 1 Day Ago

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Regional Reimbursement Specialist (Regional MDS Director)
  • Champion Care
  • Milwaukee, WI FULL_TIME
  • Due to our recent growth we are currently interviewing for a Regional Reimbursement Specialist to add to our team in Southeastern WI! At Champion Care, we are driven by a noble mission: to deliver unp...
  • 2 Days Ago

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Executive Director, CSRO
  • Executive Director, Inc.
  • Milwaukee, WI FULL_TIME
  • Executive DirectorCLIENT ASSOCIATION: Coalition of State Rheumatology Organizations, CSROPOSITION(S) REPORTS TO: EDI Consulting PartnerPOSITION(S) THAT REPORT TO YOU: Administrative/Meeting Manager, C...
  • 7 Days Ago

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Director of Environmental Services
  • Healthcare Services Group, Inc
  • Ashland, WI FULL_TIME
  • OverviewWho We AreHealthcare Services Group (HCSG) is an experienced partner managing housekeeping, laundry, dining, and nutritional services within the healthcare market. For over 45 years, we have p...
  • 2 Days Ago

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Director of Environmental Services
  • Healthcare Services Group, Inc
  • Florence, WI FULL_TIME
  • OverviewWho We AreHealthcare Services Group (HCSG) is an experienced partner managing housekeeping, laundry, dining, and nutritional services within the healthcare market. For over 45 years, we have p...
  • 1 Day Ago

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Afternoon Assistant Teacher/After Care Program Supervisor
  • Nebraska Department of Education
  • Lincoln, NE
  • Montessori School for Young Children Afternoon Assistant Teacher/After Care Program Supervisor Preferred Qualifications ...
  • 6/11/2024 12:00:00 AM

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Director
  • Leadenhall Search & Selection
  • Leadenhall Search and Selection are working with a global consulting firm, specialising in talent strategies. With a foc...
  • 6/10/2024 12:00:00 AM

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Director
  • New York Kids Club
  • New York, NY
  • Job Type Full-time Description NY Kids Club & NY Preschool is New York's premier children's enrichment space and accredi...
  • 6/10/2024 12:00:00 AM

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OR Director
  • Insight Global
  • Macon, GA
  • Insight Global is seeking the perfect candidate for a contract to hire Operating Room Director located in Macon, Georgia...
  • 6/10/2024 12:00:00 AM

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Director
  • University of Texas at Dallas
  • Richardson, TX
  • Posting Details Posting Details Posting Number S05701P Position Title Director Functional Title Director, International ...
  • 6/9/2024 12:00:00 AM

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Director
  • PRIDE Health
  • Portland, OR
  • profession: Director specialty: Rehab clientName: Reliant Rehabilitation - Glisan Care Center city: Portland state: OR s...
  • 6/9/2024 12:00:00 AM

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Associate Director/Director
  • BioPhase
  • San Diego, CA
  • We seek an enthusiastic and highly motivated DMPK Lead to join our seasoned drug discovery and early development team. Y...
  • 6/8/2024 12:00:00 AM

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Photo Director/Associate Photo Director
  • Aquent
  • Milwaukee, WI
  • FANTASTIC PHOTO DIRECTOR OPPORTUNITY RELOCATION Assistance Provided if Needed Our client, a leading provider of shipping...
  • 6/7/2024 12:00:00 AM

Wisconsin is bordered by the Montreal River; Lake Superior and Michigan to the north; by Lake Michigan to the east; by Illinois to the south; and by Iowa to the southwest and Minnesota to the northwest. A border dispute with Michigan was settled by two cases, both Wisconsin v. Michigan, in 1934 and 1935. The state's boundaries include the Mississippi River and St. Croix River in the west, and the Menominee River in the northeast. With its location between the Great Lakes and the Mississippi River, Wisconsin is home to a wide variety of geographical features. The state is divided into five dist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Services Director jobs
$149,493 to $212,881

Reimbursement Services Director in Huntington, NY
Mediware’s reimbursement team provides trusted home infusion and DME reimbursement services including complete outsourced billing and collections, consulting, due diligence services, and flexible collection project options.
February 13, 2020
Reimbursement Services Director in Salem, OR
Tuition Reimbursement Services, or Programs, are also referred to as Tuition Assistance Programs.
February 18, 2020
Reimbursement Services Director in Queens Village, NY
Manages the team member’s and workload of the Audit/Reimbursement unit to ensure compliance with the standards set forth by the Centers for Medicare and Medicaid Services (CMS).
December 17, 2019