JOB : Reconciliation Manager - (ND10307) : USA NY White Plains

Reconciliation Manager - (ND10307) : USA NY White Plains

Job Description

Purpose: To oversee the progress of Medicare revenue recovery initiatives toward financial goal established by the department, administer daily/monthly reconciliation activities to ensure compliance with Centers for Medicare and Medicaid Services (CMS) regulations, provide support and develop staff members, assume leadership role within Oxford representing Medicare Reconciliation interest, and communicating departmental needs to other departments and external constituencies.

Key Accountablities:
1. Oversee day-to-day Medicare reconciliation functions; reconcile Medicare special statuses to ensure that appropriate payment is received from CMS-communicate with CMS to resolve payment discrepancies (25%).
2. Supervise and manage perfomance of Reconciliation Associates, coach and counsel, conduct performance appraisals, set performance measurements and metrics to increase productivity and efficiency of staff members (15%)
3. Provide analytical support to department by scrutinizing onthly revenue flow, produce monthly reports to summarize payment trends, prepare financial analysis and revenue projections, report to Finance on progress of revenue recovery efforts (15%)
4. Lead encounter data submissions, analyze payment informatin in relations to risk adjusters, develop and maintain risk adjuster reconciliation process, collaborate with external vendors (15%)
5. Identify developmental needs in operations based on regulatory changes, revise current reconciliation processes andimplement process enhancements to increase efficiency and maximalize revenue recovery (10%)
6. Coordinate reconciliation efforts with internal and external constituencies to secure their participation in reconciliation efforts, communicate reconciliaton policies and procedures to internal Oxfords departments (10%).
7. Expertise in Medicare payment policies. Conduct analysis of CMS membership and payment data to identify payment trends, inconsistencies provide reports to summarize financial analyis (5%).
8. Manage Medicaid recovery initiative, report initiative progress to the risk vendors, maintain invoices (5%)
Technical Knowledge, Experience and Skills Requirements:
1. Bachelors degree required, Masters degree a plus
2. Excellen written and verbal communication skills
3. Ability to coordinate multiple projects and work with tight deadlines
4. Experience in performance management, and staff development
5. Strong analytical skills ability to understand and analyze comlex financial issues and payment methodology systems
6. Excellent organizational and time management skills
7. Ability to work independently and as well as in a team environment
8. Financial background, as well as knowledge of claims a plus

We are proud to be an EEO/AA employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse tes
Job Requirements
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