Facility

Cape Fear Valley Medical Center

Location

Fayetteville, North Carolina

Department

Reimbursement

Job Family

Management

Work Shift

Days (United States of America)

Summary

Responsible for managing all third-party activities related to Medicare, Medicaid, and Tricare for Cape Fear Valley Health System (CFVHS) facilities.

Major Job Functions

The following is a summary of the major essential functions of this job.  The incumbent may perform other duties, both major and minor, that are not mentioned below.  In addition, specific functions may change from time to time:

• Responsible for managing the legislative and regulatory requirements of the Medicare, Medicaid, and Tricare programs

• Manages the health system's reimbursement from Medicare, Medicaid, and Tricare programs

• Coordinates and assists in the timely and accurate completion of the Medicare, Medicaid, and Tricare cost reports including managing the procurement of requisite information such as program logs, financial and statistical data, physician and other required time studies and other related reports

• Coordinates any health system audits, reviews, certifications and informational requests conducted by the Medicare and/or Medicaid agencies or independent auditors

• Challenges adverse adjustments resulting from third-party audits

• Reviews changes in governmental regulations that impact the health system's reimbursement

• Monitors and controls the various third-party related activities and invoices of consultants/contractors

• Other duties as assigned

Minimum Qualifications

The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:

Education and Formal Training: 

• Bachelor’s degree in Accounting or Finance required

• Master’s degree in Accounting or Business preferred

• Certified Public Accountant preferred

Work Experience: 

• 5 years’ experience in reimbursement and/or accounting in a hospital or healthcare setting required

Knowledge, Skills, and Abilities Required: 

• Extensive knowledge of hospital billing and accounting with the ability to analyze problems as well as devise and implement improved and effective methods and procedures

• Independent judgment, excellent interpersonal skills, and the ability to grasp new concepts quickly

• Effective communication with various levels of management

• Ability to demonstrate a thorough knowledge of computer functions

Physical Requirements: 

• Visually read reports and computer display terminals

• Manual dexterity to input data via a keyboard

• Mobility for the purpose of meeting with management at service areas throughout the facility

• May require extended periods of sedentary work and extended working hours to meet stated objectives

Required Licenses and Certifications

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity