The System Director, Reimbursement is responsible for maximizing revenues for the Bon Secours Charity Health Network through the accumulation, analysis and justification of essential financial information mandated by governmental and third party reimbursement agencies, the review and monitoring of the rate and charge structure, the establishment and maintenance of a library of the rules, regulations, policies and procedures of all governmental and third party payors, monitoring changes in New York State Health Code and their impact on programs and services, and the pursuit of grants and trusts available to the Medical System.

Responsibilities:

* Works with Patient Accounts and other hospital division staff to ensure timely reimbursement criteria are adhered to for maximization of reimbursement.

* Develops, directs, and implements procedures for accumulating accurate and relevant statistical data such as patient days, outpatient and emergency room visits, equipment usage, staff allocation, and units of service provided by each division of the Medical Center using both manual and automated systems, to maximize the rates of reimbursement.

* Develops, directs, and implements programs, systems and procedures designed to determine, in accordance with mandated state and federal hospital accounting reporting systems, the total, detailed costs of the Medical Center for the purpose of allocation of costs to patient service areas in support of requests for favorable rates of reimbursement.

* Prepares various cost reimbursement and statistical reports required by governmental and third-party agencies which form the basis for reimbursement rate determinations.

* Analyzes and makes recommendations in effectively implementing the collection cycle to ensure consistent documentation flow for reimbursement.

* Analyzes the impact of rulings and adjustments to reimbursement determinations made by governmental and third-party agencies and advises hospital management personnel with recommendations.

* Prepares appeals supported by detailed rationale on existing or revised rates of reimbursement.

* Reviews the accuracy of and monitors the ongoing activities of consultants in accordance with established criteria, providing technical assistance as needed.

* Recommends alternate techniques for accumulating data on costs, statistics, patient information, etc., for the purpose of maximizing revenues.

* Develops and recommends new procedures in collaboration with patient accounts staff to improve effectiveness of existing procedures.

* Prepares, as requested, special cost analysis studies of existing and proposed programs for the purpose of advising hospital management of their feasibility from a financial standpoint.

* Develops, in conjunction with electronic data processing personnel, automated systems to facilitate the collection of statistical, cost and accounting data.

* Conducts training seminars to advise and instruct key Medical Center personnel of the systems and procedures to be implemented to develop the necessary statistical and informational base and flow required to support the reimbursement activities.

* Directs, plans, and evaluates the work of subordinate professional and clerical personnel assigned to support reimbursement activities.

* Directs and supervises the maintenance of a library of the rules, regulation policies and procedures of all third-party payors.

* Researches and applies for available grant and trust moneys available to the Medical Center through federal, state, local and private funding sources.

* Attends meetings and conferences, providing professional advice and consultation, as required.

* Performs other duties as assigned.

Qualifications/Requirements:

Experience: Five years of experience where the primary function of the position was working with diagnostic related groups and/or reimbursement methodologies, two of which must have been in a hospital division of medical records, utilization review, quality assurance, admitting, patient accounts, reimbursement, or information systems required.

Education: Bachelor's degree in Finance or related fields required.

Licenses / Certifications: N/A

Other: N/A

Special Requirements: N/A

About Us:

Good Samaritan Hospital

Good Samaritan Hospital in Suffern, NY, is a 286-bed hospital providing emergency, medical, surgical, obstetrical/gynecological and acute-care services to residents of Rockland and southern Orange counties in New York; and northern Bergen County, NJ. The hospital is home to a recognized cardiovascular program, comprehensive cancer-treatment services, the area's leading Wound and Hyperbaric Institute and outstanding maternal/child services that includes a Children's Diagnostic Center. Good Samaritan Hospital also provides social, psychiatric and substance-abuse services and its certified home-care agency supports residents of the Hudson Valley and beyond.

Benefits:

• Health Insurance
• Dental
• Vision
• Retirement Savings Plan
• Flexible Saving Account
• Paid Time Off
• Holidays
• Tuition Reimbursement