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Posted: 25-Apr-24
Location: Durham, North Carolina
Salary: Open
Categories:
Internal Number: 244453
The DUHS Reimbursement department is responsible for planning, developing, coordinating and preparing financial analysis and reporting for net patient revenue and reimbursement to support:
- AR valuation and month-end close
- Patient data and related modeling in the cost accounting system
- Managed Care contract proposals and negotiations
- Margin improvement initiatives
- Cost report submissions and audits
- Operational budgets and forecasts
- Financial plans and CON applications
The department performs complex and specialized assignments utilizing reimbursement expertise. This position reports to the Director of Cost & Revenue Accounting. This position frequently interacts with Entity Finance analysts, IT personnel, department managers, and PRMO staff.
Duties & Responsibilities
- Plan, develop, coordinate and prepare financial analysis and reporting for net patient revenue to support AR valuation / month-end close. Create ad hoc reports as needed for business questions that arise regarding gross revenue and/or modeled revenue.
- Audit, upload and post patient data into EPSi on a monthly basis; ensure all data tables needed for reimbursement modeling are loaded and updated on a regular basis. Reconcile EPSI patient data to the subledger and audit the transaction level and encounter level interfaces.
- Plan, develop, coordinate and prepare reimbursement analysis to support Managed Care contract proposals and negotiations.
- Prepare analysis and recommendations for margin improvement initiatives.
- Provide data and analysis to support the annual Cost Report submissions and audits.
- Plan, develop and assist in the creation of analytical reports and tools to support the net patient revenue budgets, forecasts, financial plans, surveys, and CON applications.
- Communicate via email distribution list any / all issues related to EPSi, such as the on-line availability, the processing schedule or data integrity issues.
- Hybrid work schedule with at least one day on-site weekly. Mandatory work on the first three days of the month, regardless of weekend or holiday.
- May involve off-site travel to hospitals within the Health System.
Key Work Style Attributes
- Ability to work under pressure, multi-task, adapt to changing priorities and produce quality work, while meeting deadlines
- Demonstrate ability to work independently with little guidance and demonstrate ability to handle and prioritize multiple assignments and overlapping deadlines
- Demonstrate initiative
- Attention to detail and accuracy are extremely important and highly valued
- Excellent oral, written and interpersonal skills mandatory
- Excellent organizational, analytical, and problem-solving skills mandatory
- Must be a team player with proven ability to interact well with all levels of management and staff
- A professional approach to work including a strong sense of responsibility for assigned duties
Minimum Qualifications
Education
Work requires a Bachelor's degree in Accounting, Finance, Economics, Business Administration, or a related field. CPA is preferred..
Experience
- Work requires a minimum of six years experience in financial management, cost accounting, or a field directly related to a specialized area of assignment.
- A minimum of six years experience in financial management, accounting or equivalent combination of education and experience
- Demonstrated understanding of hospital (inpatient and outpatient), physician, ambulatory surgical center and IDTF reimbursement methodologies
- Proficient in Microsoft Excel required; proficient in SQL preferred
Degrees, Licensures, Certifications
CPA Preferred
Duke 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.
