Director, Provider Audit & Reimbursement
New
J
JobgetherHealthcare reimbursement
Ability to work remotely from a location within one of the 50 U.S. states or the District of Columbia.Full-TimeDirector
SalaryAnnual salary range: $104,831.40–$137,936.05. Additional compensation through an incentive plan and lifestyle benefit.
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Job Details
- Experience
- At least five years of Medicare Cost Report audit and reimbursement experience, including three years managing Medicare Cost Report audit or reimbursement functions, or in an equivalent role. Preferred: at least five years of management experience overseeing complex systems and workflows.
- Required Skills
- HIPAA
Requirements
- Bachelor’s degree in accounting or a business-related field from an accredited institution, including at least 24 credit hours in accounting; or a Certified Public Accountant (CPA) credential; alternatively, 15 or more years of significant management experience in Medicare audit and reimbursement.
- Knowledge of Medicare laws, regulations, and Government Auditing Standards.
- At least five years of Medicare Cost Report audit and reimbursement experience.
- At least three years managing Medicare Cost Report audit or reimbursement functions, or experience in an equivalent role.
- Experience building and leading teams, achieving operational goals, and maintaining efficiency and service quality.
- Strong knowledge of Medicare Cost Reporting, provider audit and reimbursement operations, and applicable regulatory and compliance requirements.
- Experience with strategic planning, budget oversight, resource allocation, and performance management.
- Strong analytical, problem-solving, organizational, interpersonal, and staff-development skills.
- Understanding of HIPAA and other applicable privacy, security, and regulatory obligations.
- Willingness to travel periodically for in-person management meetings, with travel of up to 25%.
Responsibilities
- Provide strategic leadership and direction for provider audit and reimbursement teams, projects, and services.
- Ensure contractual obligations, performance standards, service metrics, and applicable regulatory requirements are met.
- Lead, coach, and develop staff while setting expectations and supporting professional growth.
- Manage productivity, performance, timeliness, problem-solving, training, and resource allocation.
- Contribute to strategic planning, set departmental goals, and identify process-improvement opportunities.
- Oversee departmental budgets and resource planning.
- Oversee responses to audit findings and ensure corrective actions and process improvements are implemented.
- Collaborate with technical and systems development teams to improve operational tools.
- Build relationships with internal and external stakeholders, including government agencies and healthcare institutions.
- Coordinate priorities and customer commitments with project management, contract administration, finance, and operational leaders.
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