Clinical Reimbursement Manager, Compliance Accounting & Analysis (Cost Reporting)
- Duarte, CA
About City of Hope
City of Hope, an innovative biomedical research, treatment and educational institution with over 6000 employees, is dedicated to the prevention and cure of cancer and other life-threatening diseases and guided by a compassionate, patient-centered philosophy.
Founded in 1913 and headquartered in Duarte, California, City of Hope is a remarkable non-profit institution, where compassion and advanced care go hand-in-hand with excellence in clinical and scientific research. City of Hope is a National Cancer Institute designated Comprehensive Cancer Center and a founding member of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers that develops and institutes standards of care for cancer treatment.
The position requires fundamental knowledge and working experience in applying the rules and regulations related to third-party cost reporting and a strong understanding of hospital operations. This is a visible role and is responsible for Medicare and Medical Cost reporting, OSHPD quarterly and annual reporting, Provider Fee analysis, 340B compliance tracking, cost report appeals, and SB1732 filings. The role provides necessary analysis and communications specific to compliance reports and provides leaders with insightful information vital to the operational decision-making process. The position will be collaborating with various teams in relation to feasibility studies and will be part of isolated projects.
Key Responsibilities include:
- Responsible for Medicare and Medicaid cost reports. This requires collaboration with various departments for the inputs. Works with an external consulting entity to facilitate the review and filing of cost reports and filings of the appeals (as necessary).
- Prepares all necessary adjustment entries for month-end/quarterly close in relation to Cost Reports, Provider Fee, Medicare Bi-Weekly payments, SB1732, and other compliance matters, as needed.
- Establishes and ensures compliance with City of Hope Accounting and Reporting Manual policies and procedures. Propose improvements as needed.
- Provides analysis and communications specific to compliance reports. Provides management with information vital to decision making.
- Analyzes complex financial and statistical data to ensure reimbursement accuracy.
- Responds to government intermediary audits and requests.
- Responsible for quarterly and annual OSHPD reports and works with external consultant to facilitate the review of the annual report.
- Stays abreast of current reimbursement issues and implements contemporary practices.
- Participation in special revenue related projects and performing additional duties as required
- Participates in feasibility studies.
- Practices a high level of integrity and honesty in maintaining confidentiality with patient related information and access.
- Any other ad hoc projects and requests.
Basic education, experience and skills required for consideration:
- Bachelor’s Degree in accounting, finance, or related field.
- 5 years of experience in Accounting/Finance with a minimum of 3 years in a supervisory/managerial capacity or 7-10 years of experience in a senior/lead level role required.
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