Duke University Health System (DUHS) Job Descriptions
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SR. DIR, REIMBURSEMENT, DUHS
Job Title: SR. DIR, REIMBURSEMENT, DUHS
Job Code: 5416
FLSA: E
Job Level: K1
Revised Date: 12/01/2020
Supervisory Responsibility: Yes
General Description of the Job Class
This position is responsible for coordinating the preparation and settlements of all cost reports and other reports to outside entities. This position will be responsible for reimbursement functions and reporting at all entities at DUHS.
Duties and Responsibilities of this Level
Reimbursement Reporting
- Oversee all reimbursement functions and supervise staff (6 FTEs
- Coordinate the preparation and documentation of Medicare and Medicaid cost reports and related filings.
- Maintain adequate schedules and analysis to support settlement accounts.
- Prepare appeals and re-openings of Medicare and Medicaid cost reports, and coordinate the accurate settlements of all issues.
- Coordinate support for audits of cost reports and other third party filings.
- When required, prepare pro forma cost reports or other analysis to evaluate proposed regulatory changes.
- Prepare other reports, such as the IRIS report, the Blue Cross report, Medicaid DSH filings, and ad hoc external reports.
- As requested, support the development of hospital and DUHS budgets.
- As requested, support the calculations of revenue deductions, contractual allowances and other reserves and settlement accounts.
- Maintain sufficient knowledge of System operations and Federal and State regulations to ensure compliance with all laws.
- Coordinate revenue maximization and initiatives and lead Finance input into compliance initiatives throughout DUHS with respect to governmental programs.
- Represent DUHS in consultations with the NC Medicaid program around reimbursement programs, including DSH. Coordinate with CFOs of other major North Carolina heakth systems, North Carolina Hospital Association and outside counsel.
General
- Contribute to development and maintenance of all department and hospital system enhancements as required, including revenue modeling.
- Ensure adherence to all third party reporting requirements.
- Participate in departmental Policy and Procedure documentation initiatives.
- Maintain necessary technical application skills.
- Perform other related duties incidental to the work described herein.
- Direct departmental personnel functions including, but not limited to, hiring, performance management, corrective action, etc.
Required Qualifications at this Level
Education
Work requires a Bachelor's degree in Accounting or Business. Advance degrees or credentials are desirable.
Experience
Work requires 8 years of relevant accounting experience in reimbursement and revenue accounting. Management level reimbursement experience at an academic medical center is required.
Degrees, Licensure, and/or Certification
N/A
Knowledge, Skills, and Abilities
Strong PC skills in applications such as Excel, Access, Word and PowerPoint are important, and experience with cost report software is essential.
Experience at a fiscal intermediary or in reimbursement consulting is considered a plus.
Strong communication skills and demonstrated attention to details and accuracy are required.
Distinguishing Characteristics of this Level
N/A
The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions
Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
