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Director of Reimbursement Services - Conshohocken, United States - Extremity Care
Description
Job DescriptionJob Description Salary:
The Director of Reimbursement Services is responsible for overseeing the reimbursement operations and revenue cycle management.
Duties & Responsibilities:
Provides leadership and knowledge to internal teams and external customers on reimbursement and claims to maximize revenue and minimize denials
Monitors, evaluates and reviews all cost reporting in support of reimbursement claims
Develops policies and procedures compliant with regulatory requirements
Oversees the collection of statistical and financial data needed for preparing reporting
Conduct education of products to internal and external customers
Develops training programs and makes formal presentations on the billing process and support services
Administers coding, billing, and coverage guidelines to reimbursement team, sales and provider accounts
Identify policy issues, implement third party reimbursement changes and communicate with Medicare contractors and commercial payers regarding medical policy and coverage guidelines
Lead reimbursement staff training and identify issues affecting reimbursement and provide solutions
Provide direction on payer strategy
Manage key relationships with providers, payers, sales force, and reimbursement team.
Coach others on current regulatory information and guidelines
Communicates relevant changes and protocol and procedural revisions to senior management and staff
Implements appropriate departmental operations changes to ensure compliance
Ensures department promptly and professionally carries out resolving issues relative to customer and reimbursement services
Evaluates payer reimbursement and trends to identify deficiencies, mitigate revenue issues and opportunities for improving payment rates and reducing denials
Provides oversight of underpayment and denial management of claims
Identifies opportunities for improvement based on organizational needs and industry standards
Promotes culture of continuous improvement
Skills & Abilities:
Solid analytical and financial management skills
Strategic planning and leadership within healthcare settings
Exceptional interpersonal skills and ability to interact with a range of internal and external customers
Excellent communication skills, including listening, writing, and presenting to groups of all sizes
Ability to work collaboratively with proficient team building skills
Education & Experience:
Bachelor's Degree in Health Administration, Finance, Business Management or related field
7 plus years of healthcare reimbursement management experience
Proficient knowledge of current regulatory
information/guidelines
Healthcare law and financial management experience
Extensive knowledge of Medicare, managed care plans, and medical billing and coding
Proven track record of developing and implementing successful reimbursement strategies
Deep understanding of payer policies and patient billing practices
remote work
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