Responsible for ensuring the appropriate governmental (Medicare and Medicaid) reimbursement is received for OhioHealth’s $3.7 billion gross patient revenue. Preparation of Medicare and Medicaid cost reports for OhioHealth’s 8 hospitals, in addition to the monthly analysis of the third party settlement accounts during month-end close. Develop proactive calculations and modeling of new governmental regulatory changes and impacts as well as variance analysis of third-party liability accounts. Coordinate filings of information with the Medicare Intermediary; such filings include, but are not limited to, fact sheet, cost reports, questionnaires, and responses to government audits, and special Centers for Medicare and Medicaid Services (CMS) requests. Ensure accuracy and timely submission of these filings. Prepare formal appeals to the Federal and State governments to establish appropriate reimbursement levels for Hospital programs and to correct reimbursement inequities. This includes working directly with both internal and external counsel on appeal matters. Additionally this position has supervisory oversight of the Reimbursement Analyst daily work schedule including flow of information, teaching of reimbursement fundamentals and principals, review of work and setting of daily priorities. Also assists in evaluating the cost/quality and feasibility of new and existing programs and joint ventures. Apply extensive interpersonal skills in communicating with all management levels of OhioHealth. Maintain a thorough familiarity with all regulations, procedures and interpretations of Federal, State and County reimbursement programs.

Manage a staff of 4 senior accountants that are responsible for the accounting and financial analysis functions of the OhioHealth Parent entity, which consists of approximately $170 million of expenses. Act as the financial liaison for Parent’s 120 cost centers in regards to their monthly income statements and annual budgets; and ensure that all cost centers are fiscally responsible and adhere to the established policies and procedures. Responsibilities include preparation of monthly financial statements and other reports; oversee and review of the monthly balance sheet reconciliations and quarterly hindsight analysis of major accruals; preparation of annual budgets; and annual updates of long-range financial plans. Daily interaction on relevant issues with the operations managers of Parent’s cost centers in addition to the other entities within OhioHealth. Complete special projects for senior management. In addition, this position collects revenue and expense reimbursement from members, affiliates, and joint ventures. Assist the year end audit through preparation of workpapers and assembly of the footnotes to the financial statements.

Prepared prospective and forecasted statements in relation to multiple assumptions including Critical Access designation. Assisted in the preparation of feasibility studies related to hospitals trying to achieve financing for new construction. Completed reopening of cost reports, in addition to creating appeal letters. Performed audit and review of client’s third party liability accounts. Participated in special projects relating to ER Availability and Bad Debt Policy review. Supervise the daily progress of engagements. Coordinating the various phases of an engagement, including job planning, scheduling and assigning work to staff members. Training of staff members; offer guidance, direction and constructive criticism of staff work; prepare constructive discussions of staff evaluation reports. Supervise the daily progress of audit fieldwork and assignments. Preparation of annual financial statements, including presentation to the Board of Directors. Organize, review and evaluate fieldwork. Complete staff performance evaluations. Plan audit engagements, including the coordination of staffing requirements and the development of risk assessments. Research accounting issues and provide technical guidance to clients. Develop recommendations for clients to improve accounting processes.

Supervised and participated in audits and desk reviews of Medicare cost reports of health care facilities by verifying, validating, and analyzing financial records and preparing schedules, detailed statements and standard audit work papers in accordance with sound accounting and auditing procedures. Assisted in the training of staff and the review of workpapers. Participated in determining the extent of the provider audit which included defining what was to be accomplished, identifying what information is needed, and determining how the audit should be approached. Prepared the management letter to be submitted to providers along with the finalized cost report. Kept abreast of changes in Medicare regulations and reimbursement and responded to inquiries regarding interpretation of new and existing provisions of Medicare regulations and their impact on specific programs. Completed special review initiatives as requested by HCFA and other customers. Performed presentations to the staff on review issues.

Auditing and accounting experience includes small businesses, governmental agencies, private industry entities, non-profit entities, and colleges and universities. Other tasks include compilations and reviews of financial statements and preparing corporate; partnership; tax-exempt; and individual income tax returns. Duties include performing audit procedures on all balance sheet and income statement accounts, assisting in planning and supervision of audit engagements; inventory observations; documenting internal control procedures of first time audit clients; and involvement in the preparation of financial statements, footnotes, management letters and special reports.

Prepared and processed individual income tax returns on the federal, state, and local levels.

Accounting experience includes providing assistance to cost accounting, accounts payable, and the TMH Foundation, in addition to completing numerous projects dealing with accounting procedures and organizational objectives.