Director Revenue Recognition - 40hrs

The Director, Revenue Recognition is responsible for monthly, quarterly, and annual revenue analysis and reporting across all hospital and specialty group departments for both Connecticut Children's Medical Center (CCMC) and Connecticut Children's Specialty Group (CCSG). The role manages State and Federal reporting requirements, directs support for DSH and other audits, and ensures revenue is recognized in accordance with contracted terms through the month-end close process. The Director analyzes payer, physician, and patient payment information against applicable contract terms, government regulations, and internal policies, and supports annual revenue budgeting and forecasting. Work is performed under general supervision in close collaboration with Financial Planning and Financial Analysts across the department.

Revenue Analysis & Reporting-40%

Prepares monthly, quarterly, and annual revenue analysis and reporting across all hospital and specialty group departments
Ensures revenue recognized for CCMC and CCSG through the month-end close process is in accordance with contracted terms for services rendered
Demonstrates technical knowledge of generally accepted revenue recognition standards specific to the hospital industry
Analyzes incoming payment information and communications from payers, physicians, and patients in conjunction with applicable contract terms, reimbursement schedules, government regulations, and internal policies
Identifies and investigates revenue variances; prepares written analysis and presents findings to leadership as needed
Monitors payer contract performance and identifies opportunities for revenue optimization or recovery
Develops productive relationships across Finance departments, including Revenue Cycle, Financial Operations, Financial Reporting, and Contract Management
Budgeting & Forecasting
Supports the annual revenue budget process, including preparation of supporting schedules and documentation
Provides regular updates to revenue forecasts, incorporating changes in payer mix, utilization trends, contract terms, and regulatory developments
Supports new business initiatives with revenue expectations and scenario modeling

Reimbursement & Compliance-20%

Supports reimbursement analysis and regulatory compliance monitoring
Ensures all actions are consistent with applicable government regulations, contractual terms, and internal policies and procedures
Maintains current knowledge of changes to CMS regulations, state Medicaid policy, and managed care reimbursement methodologies

State & Federal Reporting Requirements-20%

Completes the following requirements in a timely manner:
Coordinates information for the external preparation of the CMS Annual Cost Report
Connecticut Hospital Association Surveys
Children's Hospital Association Surveys
DSH Survey
OHS Annual Filing and OHS 12 Month Filing
CHGME Grant:
Initial Application
FTE Documentation
Reconciliation Application
Annual Report Facilitation

Audit Support-10%

Directs the preparation of support materials related to DSH audits and other audit requirements as needed
Coordinates with internal departments and external auditors to ensure timely and accurate responses to audit inquiries

Performs Other Duties as Assigned.

Education and/or Experience Required:

Education: Bachelor’s degree from accredited college or university

Experience: 5 years’ experience in Healthcare Revenue Cycle or Healthcare Finance departments

License and/or Certification Required:

None.

Knowledge, Skills and Abilities:

Knowledge:

ICD-10, CPT coding, and medical terminology
Insurance regulations and reimbursement policies, including managed care, Medicare, and Medicaid
Generally accepted revenue recognition standards specific to the hospital industry
State and Federal reporting requirements applicable to healthcare finance
CMS cost report methodology and DSH program requirements
Healthcare financial management principles, including budgeting and forecasting
Microsoft Word and Excel; experience with healthcare financial systems preferred

Skills:

Strong analytical and financial modeling skills with a high degree of accuracy and attention to detail
Proficiency in data analysis, variance reporting, and revenue reconciliation
Excellent written and verbal communication skills, including the ability to present financial data clearly to varied audiences
Strong organizational and project management skills with the ability to manage multiple deadlines simultaneously
Ability to develop and maintain effective working relationships across departments

Abilities:

Ability to interpret and apply complex regulatory requirements, payer contracts, and internal policies
Ability to work independently under general supervision while exercising sound judgment
Ability to identify problems, analyze root causes, and recommend practical solutions
Ability to adapt to changing priorities in a dynamic healthcare environment
Commitment to maintaining strict confidentiality of all financial and patient-related information