Director Reimbursement

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University of Maryland Medical System
Published
March 23, 2021
Location
Linthicum, Maryland
Job Type

Description

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Director Reimbursement

Job ID: 85962

Area of Interest: Management

Location: Linthicum,MD US

Hours of Work: M-F

Job Facility: University of Maryland Medical System

Employment Type: Full Time

Shift: DAY

What You Will Do:

General Summary

Under general supervision directs the operations of the volume and revenue capture components of the Medical Center’s Reimbursement & Clinical Economics department (including James Lawrence Kernan Hospital and University Specialty Hospital). Responsible for directing the management and senior level staff overseeing charge capture, charge master compliance and maintenance procedures, research billing compliance, and volume reporting. Responsible for the establishment of goals, objectives, and standards of performance; development and implementation of operating policies and procedures; interpretation and insurance of compliance with relevant policies and procedures, standards, regulations and codes to personnel as they relate to volume and revenue capture.

 Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Establishes standards of performance and productivity; determines staffing needs, program planning, fiscal accountability, development of policies and procedures and liaison with community programs and relevant regulatory agencies.

A. Performs individual performance evaluation and recommends and/or initiates corrective action. Establishes clear and concise work procedures and expectations, assessing performance levels by monitoring results and providing positive.

B. Promotes and encourages professional growth and development of personnel through attendance at in-services, workshops and seminars. Trains staff on new practices and promotes staff professional development.

C. Participates in the development and implementation of goals, policies, and fiscal plans for the department

2. Directs the operations of the volume and revenue capture function while applying hospital policies and procedures as well as federal, state, and local statutes or regulations governing general financial practices to insure accurate and effective service.

3. Responsible for overseeing the charge capture policies and procedures for the Medical Center (including James Lawrence Kernan Hospital and University Specialty Hospital. Maintains all aspects of the charge master including:

A. Ensures compliance with federal and state billing and regulatory requirements.

B. Develops charge capture policies and procedures for UMMC and communicates with clinical departments to ensure compliance to the policies and procedures.

C. Monitors clinical departments’ charge practices and volume levels.

D. Oversees internal monthly reporting of revenue statistics.

4. Responsible for directing the research billing and compliance function:

A. Responsible for the development and implementation of comprehensive research compliance, billing, and collection function including policies and procedures related to each operational process defined by the Research Compliance Coordinator.

B. Supports communications with senior management, academic leadership of UMAB, GCRC Staff, Medical Center clinical staff and hospital finance on matters relating to the research compliance, billing, and collections.

C. Provides research-related reporting to measure volume and revenue associated with all research studies occurring at the Medical Center.

D. Develops and implements policies and procedures related to each operational process defined by the Research Compliance Coordinator.

5. Directs a staff of managers and financial analysts in accordance with departmental and UMMC personnel policies and procedures.

6. Communicates relevant regulatory changes and/or protocol and procedural revisions to senior management and staff. Implements appropriate departmental operational changes to ensure compliance.

What You Need to Be Successful:

Education and Experience

1. Bachelor’s Degree in Accounting, Finance, or related field or equivalent experience is required. Master’s degree preferred.

2. Five years progressively responsible professional financial, reimbursement, or utilization analysis experience, or equivalent, is required. In addition, a minimum of two years management experience is required.

3. Eight years progressively responsible professional financial, reimbursement, or utilization analysis experience, or equivalent, is required, including two years of management experience.

Knowledge, Skills and Abilities

1. Knowledge of state and federal tax laws and regulations, HSCRC, and Medicare is required. Proficiency in preparing and analyzing financial data. Keeps up-to-date on changes in the hospital finance field.

2. Knowledge and ability to maintain up-to-date knowledge of current regulatory (federal, state, HSCRC, and TJC) information/guidelines and new, related hospital policies.

3. Demonstrated knowledge of Microsoft Office (Word, Excel, Powerpoint and Access) is required.

4. Highly proficient mathematical and analytical skills are required.

5. Proficient knowledge of supervising, monitoring daily work activities, evaluating, training and motivating the performance of subordinate technical, professional and clerical support staff.

6. Proficient organization and problem-solving skills are required to develop/implement efficient work processes, and to resolve difficult, conflict-oriented situations. Ability to work effectively in a stressful work environment. Ability to handle confidential issues with integrity and discretion.

7. Highly effective verbal and written communication skills are necessary to work with various clinical department heads, financial management and senior management staff and to supervise professional and clerical staff.

We are an Equal Opportunity/Affirmative Action employer.  All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

 

 

 

Terms of Service | Need help applying? Contact our HR Connections Service Center: 1-855-486-6747

We are an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law. EEO IS THE LAW

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