Anthony Mcdonald Email & Phone Number

Irving, Tx

1. Responsible for quality control and implementing the reimbursement functions at the Regional hospitals in order to complete Government required filings, determine the impact of federal regulations on hospital operations and maintain proper account analysis. Also responsible for review of third party accounts throughout the System all Region; preparation of monthly third party settlement entries for multiple assigned regions; and proper filing, audit and settlement of cost reports for multiple assigned facilities. 2. Coordinate and review processes throughout the System specific to Medicare cost report software implementation, usage and maintenance for HFS cost report software.3. Prepare and review cost reports, completing comparative analysis of the cost report versus the financial statement and compliance checklist prior to submission, for assigned facilities. Timely completion of work is required to ensure Medicare, Medicaid and CHAMPUS cost reports are submitted by due dates to prevent loss of reimbursement to the facilities. Identify and pursue proper reimbursement methodologies in an effort to receive all reimbursement due based upon Medicare, Medicaid and CHAMPUS Regulations. Responsible for mid-year and annual reviews of third party payable/receivables and providing documentation and analysis as needed to external auditors.4. Prepare monthly calculations and journal entries to properly maintain contractual allowance and related settlement accounts, for assigned facilities. Maintain current, correct account analysis related to program Income Statement and Balance Sheet accounts. Ensure monthly reports are prepared timely and accurately by supporting departmental Associates.

New Orleans

1. Maintains a team member attitude with the Reimbursement Director and Administration to ensure that Medicare/Medicaid regulations are followed in a compliant manner in the hospital.2. Oversees the preparation of the annual Medicare, Medicaid, and TriCare cost reports and ensures that they are completed accurately and timely allowing for adequate review by the Reimbursement Director prior to due dates.3. Ensures that Reimbursement analyst is timely maintaining all monthly statistics and time reports necessary for the timely preparation of the Medicare, Medicaid, and TriCare cost reports.4. Oversees the preparation of the monthly Medicare and Medicaid allowances and ensures variance analysis is performed accurately.5. Has a complete understanding of the revenue cycle and its impact on reimbursement6. Mentors the Reimbursement Analyst as instructed by the director.7. Consistently looks for ways to improve reimbursement department8. Take a lead role in the analysis and preparation of net revenue models during the annual budget process.9. All other duties as assigned.

Dallas/Fort Worth Area

Perform Financial and Compliance Hospital Audits (Medicare and Medicaid). Expected to have the competency and professionalism to be in charge of any provider serviced by Novitas. Perform supervisory reviews performed by other members of the audit staff. Prepare formal pre-audits, desk reviews, and field audit programs, applied judgment to determine the necessity for and in setting the scope of on-site audits. Prepare audit adjustment reports and maintain detailed sets of workpapers in accordance with Government Auditing Standards during the review, analysis and testwork of Bad Debt, Tefra, DSH, IME/GME, Organ Acquisition, Revenue, Expenses, Miscellaneous Income, PSR, Bonds, etc.. Professional knowledge on a variety of different cost reports, such as, Hospitals (Single and Multi PPS Units), Rehabs, Psych, SNF’s, Rural Health Centers, Home Office, etc… Analyzed expense data for reasonableness and allowability.

Baton Rouge, Louisiana Area

Oversees audit staff during audits and control consulting engagements that evaluate corporate management and operating practices. Oversees audit planning, field work, and audit reporting; prepares reports, and communicates findings and recommendations to management. Responsible for the daily supervision of audit staff and responsible for the development of audit staff and the completion of performance evaluations. Ensures that reviews are completed in compliance with the General Accepted Accounting Principles and Institute of Internal Auditor standards.

Baton Rouge, Louisiana Area

Independently conducts a broad range of complex audits assignments, included in the annual Audit Plan for any or all functions or divisions within the agency including third party contracts. These audit assignments, internal and external, are conducted to assess efficiency, economy and effectiveness of operations, verify compliance with laws and regulations and evaluate internal controls of operations and functions. Some duties includes but not limited to: 100% writing audit program for each audit, interviewing personnel, writing narratives, assessing risk, perform reviews of potential fraud situations, write and discuss findings and recommendations.

New Orleans

Prepared audit plans indicating what general requirements are needed to accomplish audit objectives. Preparing audit programs indicating how specific objectives are to be satisfied. Performed audit field work in conformance with audit programs and made necessary adjustments as possible. Finalized all work papers and communicated results via a completed, well-documented audit report. Performed all duties enumerated for lower level auditors. Performed other related work as assigned by the Director of Internal Audit or other higher-level internal auditors. Assisted in performing the annual Risk Assessment process and final audit work plan.

Dallas/Fort Worth Area

Performed Financial and Compliance Hospital Audits (Medicare and Medicaid). Prepare formal pre-audits, desk reviews, and field audit programs, applied judgment to determine the necessity for and in setting the scope of on-site audits. Prepared audit adjustment reports and maintained detailed sets of workpapers in accordance with Government Auditing Standards during the review, analysis and testwork of Bad Debt, Tefra, DSH, IME/GME, Organ Acquisition, Revenue, Expenses, Miscellaneous Income, PSR, Bonds, etc.. Professional knowledge on a variety of different cost reports, such as, Hospitals (Single and Multi PPS Units), Rehabs, Psych, SNF’s, Rural Health Centers, Home Office, etc… Analyzed expense data for reasonableness and allowability.

Dallas/Fort Worth Area

Performed Financial and Compliance Hospital Audits (Medicare and Medicaid). Prepare formal pre-audits, desk reviews, and field audit programs, applied judgment to determine the necessity for and in setting the scope of on-site audits. Prepared audit adjustment reports and maintained detailed sets of workpapers in accordance with Government Auditing Standards during the review, analysis and testwork of Bad Debt, Tefra, DSH, IME/GME, Organ Acquisition, Revenue, Expenses, Miscellaneous Income, PSR, Bonds, etc.. Professional knowledge on a variety of different cost reports, such as, Hospitals (Single and Multi PPS Units), Rehabs, Psych, SNF’s, Rural Health Centers, Home Office, etc… Analyzed expense data for reasonableness and allowability.

Master'S Of Professional Accountancy, Accounting

Activities and Societies: National Association of Black Accountants (NABA)

Bachelor'S Degree, Accounting

Activities and Societies: National Association of Black Accountants (NABA)