Shirley Ryan AbilityLab is the global leader in physical medicine and rehabilitation for adults and children with the most severe, complex conditions. By joining our team, you’ll be part of our life-changing mission and vision. You’ll contribute to an innovative, multifaceted culture that is second to none — one that embraces collaboration, excellence, discovery and compassion. You’ll play a role in something that’s never been done before as we integrate science and clinical care to help patients achieve better, faster outcomes — as we Advance Human Ability, together.
Job Description Summary
The Manager, Reimbursement and Payor Analytics will serve as an expert to senior leadership on all reimbursement methodologies and trends. The Manager will partner with Revenue Cycle Operations leadership to provide financial and analytic support and ensure proper accounting of accounts receivables. They will lead payor analytics for the contracting team and develop and maintain financial models related to potential changes in federal programs or managed care. Proactively identifies opportunities for revenue growth based on changing regulations. The Manager will play a lead role in the preparation, submission, and management of Medicare and Medicaid cost reports for the hospital.Job Description
The Manager, Reimbursement and Payor Analytics will:
Serve as central connection point between Finance, Accounting, and Revenue Cycle leadership
Work with Finance leadership to develop and implement of reimbursement strategies across all payor types including Medicare, Medicaid, and commercial insurance
Monitor legislative and regulatory changes affecting Medicare/Medicaid reimbursement, model and communicate expected impact, and implement necessary strategies
Through partnership with a third party, generate and analyze detailed AR reports using RCA software to identify trends, bottlenecks, and manage the net AR month end accounting close process
Play key role in the development, review, and submission of annual Medicare/Medicaid cost reports, ensuring accuracy and compliance with CMS guidelines and regulations
Coordinate with external auditors during Medicare/Medicaid audits and respond to audit findings
Partner with Revenue Cycle leadership to implement and manage Medicare bad debt policy and procedures.
Analyze KPIs for accounts receivable, bad debt, denials, and collection rates
Provide financial & strategic support in payor contract negotiations to optimize payment terms
Assist in the review of annual CDM price increase process
Provide reimbursement expertise in strategic financial modeling (new partnerships, expansion, etc.)
Present complex financial information to senior leadership and provide strategic recommendations
Reporting Relationships
Reports to Vice President, Financial & Strategic Insight
Knowledge, Skills & Abilities Required
Bachelor's degree in Healthcare Administration, Finance, or related field
Master's degree in related field and/or CPA preferred
Background in hospital financial operations with 5+ years of healthcare experience, with at least 2 of those years in a reimbursement role being strongly preferred; advanced degrees and/or specific relevant experience can substitute for total years of experience.
Working knowledge of CMS regulations, cost reporting principles, and healthcare reimbursement methodologies
Working knowledge of the full Revenue Cycle process and implications on net revenue and accounts receivable valuation
Familiarity with healthcare billing and coding practices and technologies
Experience in Medicare Cost Report preparation and review preferred
Experience with RCA or similar software for AR accounting and analysis preferred
Strong understanding of hospital operations and healthcare financial management
Experience with electronic health record (EHR) systems
Excellent analytical and problem-solving abilities
Strong interpersonal and negotiation skills
Ability to communicate effectively and work collaboratively with all levels of the organization
Full understanding of accounting principles relating to revenue and accounts receivable
Ability to manage multiple priorities in a fast-paced environment
Working Conditions
Normal office environment with little or no exposure to dust or extreme temperature.
Hybrid work schedule
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
Pay and Benefits*:
Pay Range:
$95,500.00 - $158,600.00Benefits:
Shirley Ryan AbilityLab offers a comprehensive benefits program that is competitive with our industry peers in our geographic locations: https://www.sralab.org/benefits
*Benefits and benefits’ eligibility can vary by position. Actual compensation will be determined by equity and qualifications of the role.
Equal Employment Opportunity Employer
Shirley Ryan AbilityLab is an Equal Employment Opportunity Employer. All applicants will be afforded equal employment opportunity without discrimination because of race, color, religion, sex, marital status, national origin or ancestry, citizenship status, age, disability, sexual orientation, gender identity, genetic information, military status, order of protection status, unfavorable discharge from military service, or any other characteristics protected by law.
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Shirley Ryan AbilityLab is an Affirmative Action Employer as required by law.