Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

Responsible for ensuring that maximum reimbursement is received from all third-party payers, all required third party cost reports are prepared and submitted in an accurate and timely manner and all essential position functions are discharged in an efficient and effective manner.

Leadership Accountabilities:

Clinical Quality Outcomes

• Establishes and maintains high standards for quality of care, & patient safety.

• Takes initiative to improve both processes and outcomes, incorporating best practices, and innovations in professional field.

• Ensures compliance with Lurie Children's policies and all accreditation & regulatory bodies and their standards.

Strategic Growth

• Compellingly communicates to staff the critical role they play in achieving Lurie Children's mission and strategic goals.

• Facilitates organizational change initiatives; leads and supports staff in adapting to a rapidly changing health care environment.

• Facilitates development and achievement of professional & personal goals for self and staff.
• Effectively recruits, orients, develops & retains a talented and diverse workforce.

Brand Identity

• Strengthens our brand as a top tier provider and employer by establishing and maintaining high standards for excellence.

• Models our values of service, innovation and teamwork. Holds others accountable for living these values.

• Fulfills the Employee Promise by fostering a challenging & compassionate work environment, recognizing strong performance, and listening and acting on feedback.

Customer Satisfaction

• Consistently models our Service Principles in internal and external interactions and ensures that the Service Principles are fulfilled to by others.
• Ensures employees receive information needed to perform jobs including feedback to enhance performance and customer satisfaction.

• Proactively addresses performance issues when indicated and administers policies, decisions, & disciplinary actions with consistency.

Financial Performance

• Aligns department goals and manages department resources and budgets to meet Lurie Children's strategic objectives.

• Helps others understand the drivers of financial success for department and Lurie Children's.

Area Specific Job Accountabilities:

• Oversee the monthly contractual allowance and reserve analysis for all payers such as Medicaid, Medicare, Blue Cross and other managed care contracts (Hospital and Physician affiliates).
• Prepares and compiles cost reports and other information as required by the federal and state laws and other third-party contractors.
• Develops strategies to maximize reimbursement and limit exposure to billing and coding compliance issues and supports the arguments required to appeal adverse reimbursement decisions by third parties.
• Supports third party contract negotiations through detailed analysis of activity, related costs and charges and assess the impact of managed care contracts on reimbursement and contractual allowances.
• Responsible for interim financial statement reporting for revenue, revenue deductions, and bad debts.
• Responsible for preparation of client prepared work papers and supporting documentation related to the year-end audit of contractual allowances, reserves and settlements.
• Develops the annual budget for contractual allowances, charity care and bad debt.
• Reviews and assesses impact to Medical Center of "proposed" and "passed" state and federal legislation.
• Maintain cost-finding statistics used for third party reporting as it relates to the Patient Accounting System.
• Assist in the preparation of the annual Form 990 Schedule H, the property tax exemption and sales tax exemption forms for the Hospital.
• Ensures appropriate information is available from research and specific purpose funds for cost reporting and indirect cost proposals. Negotiates indirect cost rates with federal reviewers.
• Acts as the Hospital liaison to fiscal intermediaries and other auditors during field audits and/or investigations regarding billing and reimbursement matters.
• Maintains third party statistical information and supplies all revenue/statistics by payor for external sources and surveys.
• Set goals and objectives, conduct the performance appraisal for and support the professional development of the Sr. Reimbursement Specialists. Supports accounting staff on technical matters related to reimbursement.
• Supports Revenue Cycle Team on technical matters related to third party reimbursement.
• Reviews and assesses reimbursement impact of Managed Care contracts and Business Development ventures (i.e., satellite partnerships).
• Active participant in system implementations related to billing, charge master and medical records.
• Finance team liaison with Business Analytics for revenue modeling, incoming transfers and payor mix monitoring related to satellite partnership operations.
• Understands the payment program specifically related to Lurie Children's Hospitals Graduate Medical Education.
• Other special projects to support the Medical Center's reimbursement opportunities.

Knowledge, Skills and Abilities:

• Bachelor's degree in accounting or finance. CPA and/or HFMA certification preferred but not required.
• Five to seven years of accounting or auditing experience with a minimum of five years of hospital third party reimbursement experience. Such experience must have provided a thorough knowledge of third-party payment principles and regulations and a comprehensive understanding of third-party cost reporting requirements.
• Must be able to display proficient skills with spreadsheet applications such as Microsoft Excel, and mainframe applications, etc.
• Demonstrated knowledge and experience using quantitative tools for problem-solving. Experience using process mapping methods, e.g., flowcharts, workflow, critical path analysis (e.g., Excel, Visio, Word, PowerPoint).
• Experience facilitating multi-disciplinary teams. Able to motivate and methodically lead a team to problem-solve to achieve desired outcomes.
• Working knowledge of major ERP applications with extensive knowledge on financial reporting tools and process improvements. Working knowledge of third-party cost reporting software applications is necessary.
• Excellent critical thinking and presentation skills; proven ability to dissect problems, recommend process/systems solutions, and develop/ communicate solutions clearly, concisely, and completely.
• Able to multitask and meet deadlines in a fast-paced environment.
• Ability to maintain a high level of integrity and confidentiality relating to patient health information (PHI) or Health Insurance Portability and Accountability Act (HIPAA). Strong planning skills as evidenced by current level of responsibility and related experience. Ability to take initiative by identifying problems, conceptualizing resolutions to the problems, and implementing change. Ability to communicate, both orally and in writing, complex technical issue in a clear, concise manner, to individuals with little or no technical background.

Education

Benefit Statement

For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:

Medical, dental and vision insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO), Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match

Various voluntary benefits:

• Supplemental Life, AD&D and Disability

• Critical Illness, Accident and Hospital Indemnity coverage

• Tuition assistance

• Student loan servicing and support

• Adoption benefits

• Backup Childcare and Eldercare

• Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members

• Discount on services at Lurie Children's facilities

• Discount purchasing program

Lurie Children's and its affiliatesare equal employment opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law.

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