Reimbursement Services Director - Home Care directs and supervises the activities of the benefits claims and provider reimbursement personnel in a home care environment. Sets procedures for filing reimbursement claims and ensures timely and accurate claims payments. Being a Reimbursement Services Director - Home Care monitors, evaluates and reviews all cost reporting in support of reimbursement claims. Produces the documentation necessary for reimbursement, Medicare Compliance, and control of receivables. Additionally, Reimbursement Services Director - Home Care may require an advanced degree. Typically reports to top management. The Reimbursement Services Director - Home Care typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Reimbursement Services Director - Home Care typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
This is a Hybrid positiion.
JOB SUMMARY:
Under the direction of PFS Leadership, the Reimbursement Specialist I is responsible for billing and collections of outstanding account balances for commercial, government, and managed care payors as assigned. The Reimbursement Specialist I is required to identify and report payor issues to their leadership. It is a requirement for the Reimbursement Specialist I to read, interpret and apply complex payor contract language to expected reimbursement calculations and pursue all payments due to the organization. The Reimbursement Specialist I must perform account collection activities utilizing internet resources and professional telephone communication etiquette. The Reimbursement Specialist I is required to compose professional written correspondence with all internal and external entities. This position expects the Reimbursement Specialist I to demonstrate organization and time management skills to manage account collections.
MINIMUM QUALIFICATIONS:
HS Diploma, GED or Equivalent
2 Years of Experience
Proficient in Microsoft Excel, Word and Outlook programs
PREFERRED QUALIFICATIONS:
Associate's degree
3 Years of Experience
The expected hiring range for this position is $20.00 to $27.50
Rady Children’s Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the “date posted” until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.