Reimbursement Services Director jobs in Wisconsin

Reimbursement Services Director directs and supervises the activities of the claims and provider reimbursement personnel. Handles third-party reimbursement for services rendered to patients. Being a Reimbursement Services Director sets procedures for filing reimbursement claims and ensures timely and accurate claims payments. Monitors, evaluates and reviews all cost reporting in support of reimbursement claims. Additionally, Reimbursement Services Director develops policies and procedures compliant with fiscal and regulatory requirements. Oversees the collection of statistical and financial data needed for preparing annual and monthly health insurance reports. May require an advanced degree. Typically reports to top management. The Reimbursement Services Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Reimbursement Services Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Director Reimbursement Analytics
  • Advocate Aurora
  • Allenton, WI FULL_TIME
  • Supports the Vice President, Reimbursement in all matters related to third-party accounting within the AAH service area. In addition, this position is to serve as a key liaison between the Reimbursement department and hospital financial leadership as well as governmental auditors and will be looked to as a departmental leader in technical issues related to the monthly financial close. Monitors proposed and final government reimbursement regulations and provides oversight in the development of the financial analysis around government and commercial reimbursement to determine the overall impact the changes have on the organization. Proposes changes to strategies to address the changes in reimbursement in order to maximize AAH’s reimbursement.

    • Oversees the completion of required monthly financial analyses for AAH hospitals to support the net revenue calculation and other reporting needs. This includes coordination and management of staff responsible for the calculation of the monthly financial statement calculations related to third-party reimbursement matters and ensuring consistency amongst all the AAH hospitals’ calculations and source data utilized.
    • Manages and maintains appropriate external relationships with the Fiscal Intermediary, IDPA, WDPA, Illinois/Wisconsin Hospital Associations and consultants engaged on behalf of Advocate Aurora as well as internal relationships with the Medical Education Department, SRCO, Payroll and General Accounting.
    • Assists departmental leadership with the valuation of required Medicare cost report reserves and Valuation Allowance accounts and assists in supporting the calculation with external financial auditors during year-end audit. 
    • Acts as AAH’s finance representative in regards to matters which relate to third party reimbursement. This can include but is not limited to participating on State Hospital Association and State Medicaid task forces and internal councils, teams, panels, educational projects and steering committees.
    • Identify, research, and initiate opportunities to enhance revenue and improve administrative efficiency of governmental payer programs while ensuring internal Advocate Aurora policies are updated and all staff are aware of and following the applicable policy points.
    • Assists in the development and forecasting of systemwide revenue budgets. Ensures that budgeting for Gross and Net Patient Revenue is accurate, timely, and complies with accounting standards. Working with members from the revenue cycle and managed care operations, leads the analysis of budget variances on a monthly basis, including the preparation of the necessary analysis to document and explain the budget variance to leadership and finance.
    • Identify, research, and initiate opportunities to enhance revenue and improve administrative efficiency of governmental payer programs while ensuring internal Advocate Aurora policies are updated and all staff are aware of and following the applicable policy points.
    • Remains up to date on reimbursement matters impacting the calculation of AAH net patient revenue and be able to disseminate such information to the team in a clear and timely manner to allow consistent and correct calculations to be performed including issues related to FASB Revenue Recognition pronouncements.
    • Assists in the development of annual departmental budgets, monitors monthly performance to budget, and when necessary initiates actions to rectify variances.

    Scheduled Hours

    Corporate business hours.  This position is primarily remote; willing to consider out of state candidates.

    Licenses & Certifications

    None Required.

    Degrees

    Bachelor's Degree in Accounting, or

    Bachelor's Degree in Finance or related field.

    Required Functional Experience

    Typically requires 7 years of experience in health care reimbursement or public accounting with a concentration in hospital auditing that includes extensive auditing of the hospital net patient service revenue area, Medicare, Medicaid, or Blue Cross.

    Required Management Experience

    Includes 3 years of management experience in managing staff and budgets.

    Knowledge, Skills & Abilities

    Ability to use Microsoft Office programs. Ability to use Medicare/Medicaid cost reporting software.  Ability to use AAH’s general ledger, accounts payable, payroll, patient accounting, and decision support systems. Must possess strong analytical and accounting skills. Must possess detailed knowledge of various reimbursement methodologies such as DRG, per-diem, capitation and percent of charges. Must possess detailed knowledge of Medicare and Medicaid reimbursement rules as well as a detailed understanding of the Illinois Blue Cross UPP system and Graduate Medical Education, Disproportionate Care, Transplant programs, and 340B issues.  Must possess the ability to work independently and under stressful conditions. Must be able to work weekends during peak cost reporting times, budget season and during year-end audit.  Must possess strong communication and interpersonal skills and the ability to communicate revenue cycle issues to all levels of the organization.  

  • 3 Days Ago

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Director Reimbursement Analytics
  • Advocate Health
  • Allenton, WI FULL_TIME
  • Supports the Vice President, Reimbursement in all matters related tothird-party accounting within the AAH service area. In addition, this position is to serve as a key liaison between the Reimbursemen...
  • 1 Month Ago

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Director, Research & Training Division and AAAIF Foundation, AAAAI
  • Executive Director, Inc.
  • Milwaukee, WI FULL_TIME
  • Director, Research & Training Division and AAAAI Foundation ASSOCIATION: American Academy of Allergy, Asthma & Immunology (AAAAI) REPORTS TO: Executive Director DIRECT REPORTS: Development Manager, Pr...
  • 8 Days Ago

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Clinical Services Director
  • Professional Services Group
  • Kenosha, WI FULL_TIME
  • JOIN OUR TEAM TODAY FOR $2,000 SIGN-ON BONUS!FLEXIBLE HYBRID/REMOTE WORK SCHEDULE! Are you a licensed mental health professional looking for a dynamic, creative, and innovative work environment? Are y...
  • Just Posted

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Human Services Director
  • Milwaukee Health Services
  • Milwaukee, WI FULL_TIME
  • POSITION SUMMARY: Responsible for ensuring the client's emotional and social needs are met and maintained individually, following policies and procedures and current federal, state, and local standard...
  • 8 Days Ago

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DIRECTOR - IT/SUPPORT SERVICES
  • Lutheran Living Services
  • Wauwatosa, WI FULL_TIME
  • The Director – IT/Support Services will oversee all aspects of information technology (I.T.), and software management throughout Lutheran Home and Harwood Place (LHHP). The Director – Support Services...
  • 16 Days Ago

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Director
  • NY Kids Club
  • New York, NY
  • Job Type Full-time Description NY Kids Club & NY Preschool is New York's premier children's enrichment space and accredi...
  • 3/27/2024 12:00:00 AM

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Director
  • St. Johnsbury Athenaeum
  • Saint Johnsbury, VT
  • Job Description Job Description ST. JOHNSBURY ATHENAEUM DIRECTOR POSITION DESCRIPTION Job Title: Athenaeum Director Repo...
  • 3/26/2024 12:00:00 AM

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Director
  • Chick-fil-A
  • Clinton, MD
  • Chick-fil-A Woodyard Landing in Clinton, MD is looking for a passionate and experienced Director to lead a seasoned and ...
  • 3/25/2024 12:00:00 AM

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Director
  • The Anderson Search Group
  • Uvalde, TX
  • Director of Client Engagement and Deposit Strategy The Anderson Search Group has been engaged by one of our top clients ...
  • 3/25/2024 12:00:00 AM

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DIRECTOR
  • The Muscogee Nation
  • Okmulgee, OK
  • MUSCOGEE (CREEK) NATION Seeking a DIRECTOR Description: The Director of Community Research and Development acts as a con...
  • 3/25/2024 12:00:00 AM

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Director
  • LEADERS OF TOMORROW LEARNING ACADEMY
  • Austell, GA
  • Job Description Job Description Oversee day to day operation of the Program Site. Facilitate administrative responsibili...
  • 3/25/2024 12:00:00 AM

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Director
  • Visa
  • Homestead, FL
  • Company Description Visa is a world leader in digital payments, facilitating more than 215 billion payments transactions...
  • 3/24/2024 12:00:00 AM

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Director
  • Gen II Fund Services LLC
  • Dallas, TX
  • New York City-based Private Equity Fund Administration Firm is looking for a Director to manage Private Equity funds. Pr...
  • 3/24/2024 12:00:00 AM

Wisconsin is bordered by the Montreal River; Lake Superior and Michigan to the north; by Lake Michigan to the east; by Illinois to the south; and by Iowa to the southwest and Minnesota to the northwest. A border dispute with Michigan was settled by two cases, both Wisconsin v. Michigan, in 1934 and 1935. The state's boundaries include the Mississippi River and St. Croix River in the west, and the Menominee River in the northeast. With its location between the Great Lakes and the Mississippi River, Wisconsin is home to a wide variety of geographical features. The state is divided into five dist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Services Director jobs
$148,023 to $210,787

Reimbursement Services Director in Huntington, NY
Mediware’s reimbursement team provides trusted home infusion and DME reimbursement services including complete outsourced billing and collections, consulting, due diligence services, and flexible collection project options.
February 13, 2020
Reimbursement Services Director in Salem, OR
Tuition Reimbursement Services, or Programs, are also referred to as Tuition Assistance Programs.
February 18, 2020
Reimbursement Services Director in Queens Village, NY
Manages the team member’s and workload of the Audit/Reimbursement unit to ensure compliance with the standards set forth by the Centers for Medicare and Medicaid Services (CMS).
December 17, 2019