Manager, Reimbursement & Payor Analytics

Benefits

Additional Information

Shirley Ryan AbilityLab is the global leader in physical medicine and rehabilitation for adults and children with the most severe, complex conditions. By joining our team, you'll be part of our life-changing mission and vision. You'll contribute to an innovative, multifaceted culture that is second to none - one that embraces collaboration, excellence, discovery and compassion. You'll play a role in something that's never been done before as we integrate science and clinical care to help patients achieve better, faster outcomes - as we Advance Human Ability, together. Job Description Summary The Manager, Reimbursement and Payor Analytics will serve as an expert to senior leadership on all reimbursement methodologies and trends. The Manager will partner with Revenue Cycle Operations leadership to provide financial and analytic support and ensure proper accounting of accounts receivables. They will lead payor analytics for the contracting team and develop and maintain financial models related to potential changes in federal programs or managed care. Proactively identifies opportunities for revenue growth based on changing regulations. The Manager will play a lead role in the preparation, submission, and management of Medicare and Medicaid cost reports for the hospital. The Manager, Reimbursement and Payor Analytics will consistently demonstrate support of the Shirley Ryan AbilityLab statement of Vision, Mission and Core Values by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute. The Manager, Reimbursement and Payor Analytics will demonstrate Shirley Ryan AbilityLab Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and Core Values (Hope, Compassion, Discovery, Collaboration, & Commitment to Excellence) while fulfilling job duties. Job Description The Manager, Reimbursement and Payor Analytics will: Serve as central connection point between Finance, Accounting, and Revenue Cycle leadership Work with Finance leadership to develop and implement of reimbursement strategies across all payor types including Medicare, Medicaid, and commercial insurance Monitor legislative and regulatory changes affecting Medicare/Medicaid reimbursement, model and communicate expected impact, and implement necessary strategies Through partnership with a third party, generate and analyze detailed AR reports using RCA software to identify trends, bottlenecks, and manage the net AR month end accounting close process Play key role in the development, review, and submission of annual Medicare/Medicaid cost reports, ensuring accuracy and compliance with CMS guidelines and regulations Coordinate with external auditors during Medicare/Medicaid audits and respond to audit findings Partner with Revenue Cycle leadership to implement and manage Medicare bad debt policy and procedures. Analyze KPIs for accounts receivable, bad debt, denials, and collection rates Provide financial & strategic support in payor contract negotiations to optimize payment terms Assist in the review of annual CDM price increase process Provide reimbursement expertise in strategic financial modeling (new partnerships, expansion, etc.) Present complex financial information to senior leadership and provide strategic recommendations Reporting Relationships Reports to Vice President, Financial & Strategic Insight Knowledge, Skills & Abilities Required Bachelor's degree in Healthcare Administration, Finance, or related field Master's degree in related field and/or CPA preferred Background in hospital financial operations with 5+ years of healthcare experience, with at least 2 of those years in a reimbursement role being strongly preferred; advanced degrees and/or specific relevant experience can substitute for total years of experience. Working knowledge of CMS regulations, cost reporting principles, and healthcare reimbursement methodologies Working knowledge of the full Revenue Cycle process and implications on net revenue and accounts receivable valuation Familiarity with healthcare billing and coding practices and technologies Experience in Medicare Cost Report preparation and review preferred Experience with RCA or similar software for AR accounting and analysis preferred Strong understanding of hospital operations and healthcare financial management Experience with electronic health record (EHR) systems Excellent analytical and problem-solving abilities Strong interpersonal and negotiation skills Ability to communicate effectively and work collaboratively with all levels of the organization Full understanding of accounting principles relating to revenue and accounts receivable Ability to manage multiple priorities in a fast-paced environment Working Conditions Normal office environment with little or