This of Regulatory Compliance is responsible for timely completion/filing of Medicare and Medicaid cost reports and responses to intermediary inquiries and correspondence, inclusive of gathering, compiling, and inclusion of financial and statistical data necessary for compliance with federal and state regulatory requirements. Actively participates and takes a leadership role in dissemination of federal and state regulatory requirements regarding Medicare, Mediciad and Champus billing, coding and financial reporting. Prepares analytical information to educate management regarding the financial impact to Methodist Health System (MHS) of changes in Medicare/Medicaid and Champus payment rules. Additionally is managerially responsible for the accurate and timely maintenance of computerized master files regarding physicians, patient service price, and CPT codes.
Your Job Requirements:
College accounting/finance degree with demonstrated knowledge of accounting theory.
Two years experience with the Medicare Intermediary or five years with a multi-hospital organization in Medicare Reimbursement.
Graduate degree in relevant healthcare/business studies preferred.
CPA Highly Preferred
Position requires extensive knowledge of governmental programs ( Medicare and Medicaid).
Good written and oral communication skills. Good interpersonal skills.
Must be able to manage time in order to meet concurrent deadlines
Your Job Responsibilities:
Direct staff and participate in the completion of annual cost reports for 4 acute care hospitals and corporate home office cost report in an accurate and timely manner. Reports should be completed in a manner that is in conformance with all current rules and regulations.
Maintain current knowledge of all Medicare and Medicaid laws/regulations applicable to Methodist Health System (MHS) services and assuring MHS compliance with rules and communicate information to the appropriate personnel.
Direct the required maintenance of the Epic and Legacy Meditech dictionaries assigned to them or their employees. (Charge Description Master, Room, and bed, etc. ). Assure that the correct coding of the CDM is occurring (UB Rev codes, CPT codes, HCPCS level codes) accurately and timely. Communicate with appropriate personnel in the establishment of new departments/cost centers and service codes.
Actively participate in the governmental compliance efforts that occur at MHS. Actively participate as a member on the Coding and Billing Compliance Committee. Assure that all actions coming from the compliance committee related to the control dictionaries are accurately implemented and verify that MHS is in compliance with laws and regulations. Work with the business office and Medical Records to help assure that MHS is billing appropriately and that the two departments have necessary information in order to remain in compliance with billing and coding requirements.
Direct staff and participate in the audit of the Medicare/Medicaid cost reports and all settlement issues related to cost report reopenings. Inform upper management of presence and the potential effect of all reopening issues.
At the end of the annual cost reporting cycle for the four hospitals and corporate home office prepare a FULL COST AND MODIFIED DEFINED COST cost report for all five reports. This is to include separate cost reports for Traditional Medicare, Traditional Medicaid. Medicare Managed Care and Medicaid Managed Care. (Total of 16 cost reports). Prepare the Excel workbooks necessary to summarize these two types of cost reports for Medicare IP & OP, Medicaid IP & OP, Medicare Managed care IP & OP, Medicaid IP & OP, Combined Medicare Traditional and Managed Care and combined Medicaid Traditional and Managed Care for presentation to Senior Management. These need to be completed by July of the following year
Provide analysis of various proposed rule changes through out the year. Proforma work for new programs, evaluations of revenue margins using the cost report as a basis for models.
Methodist Health System is comprised of four thriving hospitals serving the southern perimeter of the Dallas and Fort Worth Metroplex. Methodist Dallas Medical Center is one of Dallas' finest and largest not-for-profit hospitals. This 515-bed major teaching and referral facility is the flagship hospital for Methodist Health System. Located just 10 minutes away, Methodist Charlton Medical Center is... a modern 269-bed facility located in the suburbs of Southwest Dallas County. Opened in December of 2006, Methodist Mansfield Medical Center is a state-of-the-art 168 bed, full-service hospital located in Mansfield, TX south of Arlington and Fort Worth in Tarrant County. Methodist Richardson Medical Center, a 205-bed acute care hospital, serves residents of Richardson, Plano, North Dallas and the surrounding communities. Additionally, Methodist Family Health Centers have been established to better meet healthcare needs in the outlying communities.