Reimbursement Services Director directs and supervises the activities of the claims and provider reimbursement personnel. Handles third-party reimbursement for services rendered to patients. Being a Reimbursement Services Director sets procedures for filing reimbursement claims and ensures timely and accurate claims payments. Monitors, evaluates and reviews all cost reporting in support of reimbursement claims. Additionally, Reimbursement Services Director develops policies and procedures compliant with fiscal and regulatory requirements. Oversees the collection of statistical and financial data needed for preparing annual and monthly health insurance reports. May require an advanced degree. Typically reports to top management. The Reimbursement Services Director 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 typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
The Reimbursement Services Manager provides direction and supervision for the Reimbursement Service team to ensure timely billing and accurate collections for all billable services.
ESSENTIAL FUNCTIONS
1. Manage the day-to-day operational requirements of the Department.
2. Trains, assists, and advises Reimbursement staff.
3. Works with each staff member to identify and solve reimbursement issues and problems.
4. Reviews A/R aging for timeliness of billing and payments.
5. Reviews Explanation of Benefits for accuracy, correcting billing if necessary.
6. Maintains special billing functions.
7. Ensures correct contract rates are loaded into the EMR and reimbursed according to contract rates.
8. Ensures denials are worked in a timely and accurate manner.
9. Has the capacity to create detailed reports analyzing billing trends and systemic causes of denials and under-payments.
10. Assists the Finance Manager with special projects.
11. The employee must work well under pressure meeting multiple and sometimes conflicting deadlines.
12. The employee shall, at all times, demonstrate cooperative behavior with colleagues, supervisor and clients.
13. Participate in the recruitment and interviewing of prospective staff employees.
14. Monitors the compliance of staff with company policies and procedures.
15. Provides customer service to internal and external customers and stakeholders.
16. Willingness to learn.
17. Other duties as assigned.
Required:
Two or more years of experience in a leadership role.
Ability to obtain Arizona Fingerprint Clearance Card.
At least 21 years of age or older.
Valid AZ driver's license.
Interpersonal relationship skills.
Complex problem-solving skills.
Technical skills.
Computer software skills.
Resource management skills.
Preferred:
Bachelor's Degree.
Experience or training equivalent to three years in A/R and Revenue Cycle Management functions.
Experience in computerized accounting or Electronic Medical Record (EMR) systems.
Post High School education in use of computerized systems.
Computer keyboard.
10 key by touch.
Excellent computer skills in a Windows environment.
Job Type: Full-time
Pay: From $32.26 per hour
Expected hours: 35 – 40 per week
Benefits:
Schedule:
Experience:
Ability to Commute:
Ability to Relocate:
Work Location: In person