One of the nation’s leading providers of healthcare services, HCA is made up of locally managed facilities that include more than 250 hospitals and freestanding surgery centers located in 20 U.S. states and in the United Kingdom.
We are committed to delivering healthcare as it should be: patient-centered and for the good of all people, no matter their circumstance.
Assist hospitals to obtain appropriate reimbursement from the Medicare and Medicaid programs by analyzing new service opportunities. Assuring that hospitals understand data requirements for Medicare cost reporting and accounting and serving as a resource to hospitals and the Division Office for reimbursement questions. Requires the visiting of hospitals to gather information related to 855 filings, ESRD, provider based attestations, training of new controllers on exhibit preparation, assisting in monthly close process, assisting hospitals in budget preparation of contractuals and meetings with MAC and state auditors who perform periodic hospital audits. Will attend state Medicaid meetings and other task force meetings as a representative of HCA and/or the hospitals within the particular state.
Perform feasibility analysis and/or due diligence related to Medicare/Medicaid reimbursement for syndications, purchase/sales and mergers of hospitals, establishment of skilled nursing facilities and establishment of distinct part units. Implement or coordinate the implementation of third party accounting system and ensure it is maintained and identify documentation necessary for completion of annual cost report for all new hospitals.
Provide hospital management teams with education related to new inpatient units and other outpatient entities. Coordinate geographic reclassifications along with the filing of Provider Based Attestations. Evaluate profitability of hospital operations. Communicate with the Reporting Directors and coordinate any changes in operation which could have a material effect on conversion factors. Assist hospital and Division Chief Financial officer in review of contractual adjustment budgets. The Division Director also will take an active role in month-end close.
The Division Director will also be responsible for completion of Various HCA Home Office Pooled and functional workpaper sets.
Meet with outside CPA firms who are now required to render independent audits on a yearly basis of hospital data utilized in the state DSH programs for comparison to state DSH-FMAP limits. Provide assistance to hospital management team in filing and completing the Medicaid Provider Agreement renewals.
Federal regulations are rapidly changing in areas dictated by the rules under the Accountable Care Act and other changes occurring in Medicare regulations such as DSH, ACO’s and value based purchasing. The Division Directors of Reimbursement are responsible for educating the hospitals and working with the Divisions to implement the ACA requirements along with determining the financial effects of the regulations.
File geographic reclassifications. Ensure that the hospitals are maintaining the documentation and statistical information for completion of annual cost report. Monitor all changes in Medicaid and Tricare reimbursement and communicate to hospitals, division office and cost report preparation staff.
Reimbursement takes an active role in state Medicaid committees representing proprietary hospitals. Generally Reimbursement personnel are located in cities which allow them quick access to committee meetings held with state healthcare officials. Division Directors has provided testimony and assisted lobbyists in the drafting of state health plan rules.
During 2016 Division Directors have assisted hospitals in the input of HiTech attestations for HiTech payments. Additionally, provide audit support to the hospital management team for CMS Meaningful use HITECH audits.
Division Directors have assisted hospitals and worked with outside law firms in the review of licensure and 855 filings. In addition Division Directors have assisted in the filings of required documentation related to new hospital purchases and coordinated the sale of facilities answering questions for new owners. Division Directors have been the go to persons for gathering information from sold hospitals for filings of cost reports on sold hospitals.
The Division Director works with GME program directors to make sure FTE’s are properly counted, Resident faculty contracts are properly signed, affiliation agreements are in place by 7-1 of each program year and make sure all residents are counted in their proper program category and resident year for cost reporting purposes.
The Reimbursement Division Director is generally located in the Division office but is not considered division operations personnel.
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• Post ID: 51631648 houston