Job Description

Advisor, Revenue Integrity - Government Reimbursement

Cancer care is all we do

Hope in healing

Cancer Treatment Centers of America® (CTCA), part of City of Hope, takes a unique and integrative approach to cancer care. Our patient-centered care model is founded on a commitment to personalized medicine, tailoring a combination of treatments to the needs of each individual patient. At the same time, we support patients’ quality of life by offering therapies designed to help them manage the side effects of treatment, addressing their physical, spiritual and emotional needs, so they are better able to stay on their treatment regimens and get back to life. At the core of our whole-person approach is what we call the Mother Standard® of care, so named because it requires that we treat our patients, and one another, like we would want our loved ones to be treated. This innovative approach has earned our hospitals a Best Place to Work distinction and numerous accreditations. Each of us has a stake in the successful outcomes of every patient we treat.

Job Description:

The Advisor, Revenue Integrity-Government Reimbursement is responsible for overseeing reimbursement from government payer programs and ensuring compliance with reporting requirements.  These activities include the timely and accurate filing of all cost reports, wage index, and ongoing provider enrollment maintenance correspondence. The Advisor is responsible for internal communication with the central billing office, accounting, and managed hospitals’ finance teams regarding changes in rates, interim payments, bad debt logs, resident time sheets, and accuracy of third-party reserves. The Advisor will also be expected to provide proactive guidance to management to understand the impact of proposed or finalized changes to the government payer programs such as MACRA, EHR incentives, etc.

Job Responsibilities

50%| Ensure the timely and accurate submission of all required cost reports.  That currently includes cost reports with Medicare and Medicaid, as well as Champus capital/DME reimbursement requests for five short-term acute care hospitals.  In addition, there is also a home office cost report for Medicare.  Maintain proper analytical procedures to ensure oversight on trends that could adversely affect reimbursement such as changes in cost to charge ratios, increases in disallowed cost, and quality of supporting documentation for physician education and bad debt logs.  Keep adequate internal records in order to support the cost report audits.

20%| Provide support for program auditors and represent CTCA in all cost report or reimbursement related audit/appeal activity.  Ensure that cost report settlement payables are reserved in advance and submitted on time, or that settlement receivables are processed accordingly.  When appropriate, the Advisor also leads any cost report reopenings or appeal cases.

20%| Perform periodic review of government program reimbursement to identify potential under or overpayments and communicate the results internally and externally to maintain compliance with program regulations.  Keep the rates and weights current in CTCA’s billing system and ensure that the accounting function’s monthly reserves for government AR are accurate.

10%| Receive, interpret, and communicate to the appropriate managers any new program regulations, guidelines or requirements pertaining to reimbursement.  In addition, review reimbursement department policies from time to time-as well as the policies of any other department that affect Medicare reimbursement-for Program compliance and business effectiveness.

Skills, Education and Additional Information

  • Minimum of a BS/BA in Business, Finance, Accounting, or related field.
  • Must have minimum of 3-5 years healthcare finance experience with demonstrated knowledge of cost reporting and government payer oversight.
  • Must have a strong background in financial analysis and cost accounting. 
  • Thorough understanding of Microsoft Excel is necessary, and experience with cost reporting software is highly desirable. 
  • Candidate needs to be familiar with Medicare language, terminology, and program guidelines.

We win together

Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us. 

Visit:  Jobs.cancercenter.com to begin your journey.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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