
Facility
Cape Fear Valley Medical Center
Location
Fayetteville, North Carolina
Department
Reimbursement
Job Family
Management
Work Shift
Days (United States of America)Responsible for managing all third-party activities related to Medicare, Medicaid, and Tricare for Cape Fear Valley Health System (CFVHS) facilities.
The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time:
Responsible for managing the legislative and regulatory requirements of the Medicare, Medicaid, and Tricare programs
Manages the health system's reimbursement from Medicare, Medicaid, and Tricare programs
Coordinates and assists in the timely and accurate completion of the Medicare, Medicaid, and Tricare cost reports including managing the procurement of requisite information such as program logs, financial and statistical data, physician and other required time studies and other related reports
Coordinates any health system audits, reviews, certifications and informational requests conducted by the Medicare and/or Medicaid agencies or independent auditors
Challenges adverse adjustments resulting from third-party audits
Reviews changes in governmental regulations that impact the health system's reimbursement
Monitors and controls the various third-party related activities and invoices of consultants/contractors
Other duties as assigned
The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:
Bachelor’s degree in Accounting or Finance required
Master’s degree in Accounting or Business preferred
Certified Public Accountant preferred
5 years’ experience in reimbursement and/or accounting in a hospital or healthcare setting required
How long would it take you to prepare 5 hospital Medicare cost reports?
Extensive knowledge of hospital billing and accounting with the ability to analyze problems as well as devise and implement improved and effective methods and procedures
Independent judgment, excellent interpersonal skills, and the ability to grasp new concepts quickly
Effective communication with various levels of management
Ability to demonstrate a thorough knowledge of computer functions
Visually read reports and computer display terminals
Manual dexterity to input data via a keyboard
Mobility for the purpose of meeting with management at service areas throughout the facility
May require extended periods of sedentary work and extended working hours to meet stated objectives
Required Licenses and Certifications
Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity

Cape Fear Valley Health is a 988-bed, 8-hospital regional health system, the 8th largest in North Carolina, with more than 1 million inpatient and outpatients annually. A private not-for-profit organization with 7,500 employees and 1,000+ physicians, it includes Cape Fear Valley Medical Center, Highsmith-Rainey Specialty Hospital, Cape Fear Valley Rehabilitation Center, Behavioral Health Care, Bladen County Hospital, Hoke Hospital, Health Pavilion North, Health Pavilion Hoke and Harnett Health.
Cape Fear Valley has been nationally recognized by:
Healthgrades as a Top 100 Hospital for Cardiac Care and Coronary Intervention
IBM Watson as a Top 50 Cardiovascular Hospital
The Leapfrog Group Grade-A for Patient Safety
North Carolina-Designated Level Three Trauma Designation
The Joint Commission: Disease Specific Certification in:
• Hip Replacement Surgery (Cape Fear Valley Medical Center and Hoke Hospital)
• Knee Replacement Surgery (Cape Fear Valley Medical Center and Hoke Hospital)
• Heart Failure
• Advanced Stroke
• AMI: Acute Myocardial Infarction
• Pneumonia (Cape Fear Valley Medical Center and Bladen County Hospital)
• Advanced Perinatal Care
• Sepsis (Cape Fear Valley Medical Center and Bladen County Hospital)
• Wound Care (Highsmith-Rainey Specialty Hospital)
• Chest Pain (Hoke Hospital)
• Acute Stroke Ready (Hoke Hospital)
American College of Cardiology: Chest Pain Center Accreditation
American College of Surgeons National Accreditation Program for Bariatric Surgery: Comprehensive Center
American College of Surgeons Commission on Cancer: Cancer Center Accreditation
American College of Surgeons National Accreditation Program for Breast Centers: Breast Care Center Accreditation
Commission on Accreditation of Ambulance Services: EMS