- Leads and Manages daily team operational workflows, including:
- Submission of documentation requests to physicians
- Successful receipt of medical records/documentation/prescriptions from physicians
- Timely and accurate verification of patient benefits across all payers (Medicare, Medicaid, commercial insurance)
- Timely response to audit/medical record requests
- Documentation management
- Ensures workflows are in compliance with related laws, regulations and company directives
- Utilizes a data driven approach to oversee all workflows of the department that will maximize both production and quality standards
- Analyzes reports, records, and other metrics to confer with staff for efficient planning and staff utilization
- Create new and evolve current processes by identifying opportunities through available reporting metrics to improve profitability and patient satisfaction
- Proactively builds and implements key KPI's to increase quality, financial performance (Doc OPEX goals) and service levels
- Leads and motivates the team for maximum employee engagement
- Provide coaching and feedback to the representatives based on performance levels
- Fosters a collaborative team environment, that is results driven and adheres to the HDIS Core Values: Integrity, Compassion, Excellence, Respect and Commitment to Quality.
- Engages cross-functionally as a go to problem solver, based in knowledge of reimbursed activities in Medicaid and Medicare
- 5-10+ years of operations experience managing/supervising in operations within healthcare industry
- Thorough knowledge and experience of the rules and regulations associated with managed care, insurance, Medicare and Medicaid.
- Brightree Experience preferred
- Experience working in a matrix organization with the ability to manage multiple priorities across various stakeholders and departments
- Advance computer skills and proficiency in MS Excel required; intermediate skills and proficiency in Outlook and PowerPoint required
- Demonstrate a thorough knowledge of the rules and regulations associated with Medicare, Medicaid and commercial insurance organizations
- Strong leadership acumen; problem solving skills, successful team management and development
- Demonstrated strong analytical, quantitative, and logical thinking skills
- Extensive problem-solving capabilities
- Strong written and verbal communication skills
- Attention to details and accuracy along with strong organization skills
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Senior Manager, Reimbursement - St Louis, United States - Attindas - US
Description
Position at Attindas - US
Attindas Hygiene Partners designs, manufactures, and markets absorbent hygiene products. The company sells adult incontinence and infant diapers, among other products, into the healthcare, retail, and direct-to-consumer channels under brands including Attends, Indas, and Comfees as well as a wide range of private label brands for retailers.
Attindas' Incontinence Supplier, Home Delivery Incontinent Supplies Co. (HDIS) located in St. Louis is looking a Sr Manager of Reimbursement to join the team
For over 35 years, HDIS has believed in treating our customers with the same compassion and care that we offer members of our own families. We believe in working to improve the quality of life for the users of our products and their caregivers by building long-term relationships. When HDIS is done, we want to have made a difference in our own lives and in the lives of millions of extended family members, our customers.
Mission: We champion health, dignity and comfort.
Vision: To be a global leader in absorbent hygiene by meeting consumers' diverse needs through effective, affordable and widely available personal care solutions.
Our Values: Caring, Agile, Innovative, Unique, Personal, Genuine
Job Summary:
The Sr Manager of Reimbursement will oversee daily operations of reimbursed activities by working closely with the Associate Director of Reimbursement to implement business strategy through efficient management of our workflow and work cross-functionally across departments to meet strategic objectives. Through collaboration with staff, the director will identify internal and external customers and their expectations, to initiate process changes that will increase quality, decrease costs and that will improve staff, managed care plans and patient satisfaction. The leader will also assist in the establishment of departmental strategies, objectives, quality improvement initiatives that eliminate inefficiencies and improve return on investment (ROI) by evaluating new processes.
Key responsibilities:
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