Contract Utilization Review Jobs in Appleton, WI

SUMMARY STATEMENT

Supports the mission, vision, and values of the organization.

Responsible for planning, coordinating, managing and directing the financial performance of PRN Home Health & Therapy, including  financial and statistical reporting, cost reporting, accounts payable, billing and accounts receivable management and budget preparation.

RESPONSIBILITIES AND DUTIES

1. Manages and oversees all daily accounting operations and accounting information systems including payroll, accounts payable, accounts receivable, general ledger, financial reporting, and statistical reporting systems.  Implements financial policies, accounting systems and cost controls.
2. Ensures financial record systems are maintained in accordance with generally accepted accounting principles and in compliance with local, state, and federal laws and ACHC accreditation standards.
3. Assists in the preparation of the annual budget.
4. Oversees and is responsible for the management of all accounting information systems
5. Oversees and ensures maximum third-party reimbursement through efficient billing and collections operations, effective accounts receivable management including working with 3rd party billing companies and insurance companies. .
6. Protects the assets of the organization through effective internal controls, and direct supervision of financial operations.
7. Manages and controls cash disbursements through an effective accounts payable system.
8. Review of financial statements prepared by outside 3rd party includes doing an analysis of financial trends.
9. Prepares and reports key statistics through the effective utilization of
   information systems.
10. Provides leadership in strategic financial planning including identifying opportunities for improved fiscal viability
11. Responsible for the preparation of the annual Medicare cost report and serves as the organization liaison to the Medicare fiscal intermediary.
12. Acts as the financial liaison to the Governing Body and attends meetings as requested by the Administrator.

DUTIES:

1. Oversees payroll practices and collaborates with other members of the management team in establishing personnel policies that assures compliance with state and federal regulations, including wages, salaries and benefit regulations
2. Evaluates financial provisions of proposed contracts and agreements for provision of services to optimize financial viability of the agreements.
3. Stays informed about changes reimbursement, laws, and financial requirements, and shares information with appropriate organization personnel.
4. Oversees Finance Department. Participates in hiring, onboarding, disciplining and training of finance personnel. Conducts performance reviews for financial team. 
5. Document communication with patients, financial representatives, payors, etc. appropriately in patient chart related to payments.
6. Attend and participate in leadership meetings, staff meetings, or other meetings as required.
7. Act in compliance with PRN Home Health and Therapy Management policies and procedures, State, Federal and Professional Organization regulatory and professional standards and guidelines.
8. Participate in quality improvement processes as directed by the organization.
9. Complete all documentation, payroll, billing, and required reporting accurately and in a timely manner.
10. Maintains patient and organization confidentiality at all times
11. Perform other duties as assigned.

Position REQUIREMENTS

1. Minimum of Bachelor’s Degree in Accounting (preferred), Finance, or Business Management, related field or equivalent experience.
2. Excellent verbal and written communication skills
3. An ability to work individually or in a team environment; Self-directing with the ability to work with little direct supervision
4. Good judgement and discretion when dealing with sensitive topics
5. Able to interact with many people and multiple interruptions while staying on task
6. Extensive knowledge and experience in Microsoft Office programs, including Excel and Word
7. Demonstrates tact, patience and good personal hygiene
8. Excellent oral and written communication skills
9. Able to supervise others in a team-oriented environment
10. Extremely high attention to detail and accuracy
11. Prefer prior experience working in healthcare operations and with insurance reimbursement
12. Prefer prior experience working with Sage

PHYSICAL DEMANDS & WORK ENVIRONMENT

1. Able to work in office environment which may include sitting. standing at desk for extended time frames