Reimbursement and Revenue Cycle Manager

This role is based in Stamford, CT and will work a Monday-Friday schedule.

Responsible for the completion and analysis of the Medicare, Medicaid, CT OHS, third-party cost reports, other and reporting. This position will be responsible for reviewing, maintaining and keeping management updated on all system, payor and internal issues that impact reimbursement and the revenue cycle, including assisting with CDM maintenance. This position will work closely with Contracting, Business Office, Operations, and other Partners to review and reconcile proration rules and evaluate managed care contract performance.

This position will be responsible for the month end close process pertaining to Net Accounts Receivable. The position will have an active role in the statistic/revenue budget development and monthly variance analysis.

MAJOR ACCOUNTABILITIES/CRITICAL RESPONSIBILITIES

Completion and/or facilitation of the Medicare and Medicaid cost reports and audits.

Oversees the daily functions of the Reimbursement Department, ensuring that staff are cross-trained and process cost reports in a timely manner. This would also include overseeing the Chargemaster group as well, including compliance with all Federal and State regulations.

Also supervises and coordinates analyses required to complete the third party cost reports.

Participate in the completion of required State of Connecticut Office of Health Care Access reporting including Certificate of Need reporting and year-end annual filings.

Assist in the yearly budget process pertaining to expected changes for all third party reimbursement.

Oversee completion and analytics concerning month end AR valuation, statistical and revenue results.

In conjunction with Contracting and Business Office, assist in the evaluation of prorations and contract performance by managed care payors.

Perform special projects as requested by Finance leadership.

QUALIFICATIONS/REQUIREMENTS

Bachelor’s degree required.

MBA, CPA, or other Business/Healthcare Master’s degree preferred

3 years of leadership experience preferred.

Either 3-5 years of experience preparing Medicare cost reports or 3-5 years of experience working in a hospital Accounting or Finance Department.

Proficiency with hospital financial/billing/claims data compiling and analysis

High level of literacy with personal computer desktops (p. c.’s), including prior experience importing & exporting data files. Demonstrated abilities using Microsoft Excel and prior exposure to reimbursement or cost accounting software. Ability to work in Epic, and Oracle.

At Stamford Health, we believe that every patient deserves compassionate, personalized, person‑centered care. This commitment guides how we care for patients, support their care partners, and promote the wellbeing of our staff. In alignment with our Planetree philosophy, the individual in this role will foster a respectful, collaborative environment that honors the needs, values, and preferences of every person we serve and the colleagues we partner with.