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Reimbursement Manager

Reimbursement Manager

Job ID 
2018-1835
Location 
US-TX-Dallas
Metro Area 
Dallas/Fort Worth, TX
Function 
Revenue Cycle Management
Employment Status 
Full-Time

More information about this job

Overview

U.S. Anesthesia Partners (USAP) is the largest single-specialty anesthesia practice in the country with over 4,000 clinical providers and associates.  By joining our team you will participate in a highly collaborative and dynamic environment.  As an organization we are mission focused on delivering the highest quality in patient care and you will be directly supporting our talented clinical team.  We extend this same commitment to quality to our associates and supply tools and resources that will ensure we win in the healthcare marketplace and support of USAP.

 

We are proud of our inclusive people culture that supports our associates to perform at their best.  USAP is an equal opportunity employer.  Candidates with physician services or related health care experience is a plus. We offer a competitive benefits package. 

 

POSITION SUMMARY: Provides staff supervision and support to Payer Compliance Management associates. Compiles and produces daily, weekly and monthly reports to management as requested.

Responsibilities

ESSENTIAL DUTIES AND RESPONSIBILITIES (include but not limited to):

 

  • Provide detailed monitoring and analysis of the Payer Compliance Management System. Manage and monitor active inventories, monitor staff work assignments, evaluate workflow efficiency, identify department backlogs, identify negative payer trends, root cause known issues and resolve as quickly as possible.
  • Monitor Inventory and employee worklists (ETM queues) to ensure invoices are being reviewed for adequate and timely reimbursement, in addition to providing ongoing staff supervision and training.
  • Identify operational defects and partner with cross-functional leaders to resolve
  • Partner with Payer Relations Manger to enhance billing system term logic.
  • Partner with USAP regional leadership to ensure standardized processes across PCM teams
  • Compile reports, create and work spreadsheets to assist Manager with research and analysis of payer reimbursement trends.
  • Ensure that large payer appeal projects are submitted to the Payer Relations Manager consistently and timely with adequate report-outs to leadership.
  • Regularly track and monitor productivity and accuracy of staff members. Work to ensure ongoing follow up and communication with each employee to keep them aware of the standards of performance expectations. Maintain reports with daily, weekly, monthly and YTD data. Incorporate data into annual performance review process and quarterly bonus calculations.
  • In conjunction with Payer Relations Manager and Training department, provide training and on-going education for all PCM staff members and assist with annual reviews.
  • Work with HR on recruiting issues and interviews of prospective employees.
  • Encourage employees to improve their skills and to expand their expertise.
  • Ability to manage multiple tasks and work independently with high level of accuracy
  • Identify and help develop strategies to resolve problems impacting an efficient revenue cycle.
  • Enforce company policies as well as rules and guidelines of the Payer Compliance Dept.
  • Monitor staff attendance, provide counseling as appropriate.
  • Resolve personnel issues in conjunction with Shared Services Director and Human Resources.
  • Act as an effective liaison with management and line staff in other departments as needed to address problem areas and assist with resolution.
  • Maintain OSHA and HIPAA compliance.
  • Delegate work as necessary to stay current with priority tasks.
  • Maintain strictest confidentiality
  • Perform other duties as assigned

Qualifications

JOB REQUIREMENTS (Knowledge, Skills and Abilities):

  • Excellent Verbal and Written skills
  • Ability to prioritize work
  • Ability to successfully manage multiple projects at one time
  • Advance Excel skills
  • Strong analytical skills; ability to gather, analyze and report on information from multiple sources (i.e., Billing System, Internet, Payer Contracts)
  • Skilled in calculating charges, payments and adjustments per established guidelines
  • Knowledge of managed care contracts
  • Excellent verbal and written communication
  • Ability to work effectively and independently with staff, physicians and external customers
  • In-depth knowledge of Commercial, Medicare, Medicaid, Workers Compensation guidelines and billing standards
  • In-depth knowledge of revenue cycle management systems and the ability to adapt prior knowledge to current software
  • In-depth knowledge of financial class setup and payer setup
  • Ability to work effectively and independently with staff, physicians, and external customers
  • Must have strong computer skills with knowledge of Microsoft Word, Excel and PowerPoint
  • Must have a pleasant disposition and high tolerance level for diverse views and opinions
  • Ability to work independently with minimal supervision
  • Ability to motivate diverse personalities within the departments
  • Communicate well with the public
  • Ability to read, write, and speak English 

EDUCATION/TRAINING/EXPERIENCE:

  • A minimum of a high school diploma is required. Associate’s or bachelor’s degree in a business or health related field highly preferred
  • Prefer a minimum of 5 years of experience in Payer Contracting, Managed Care, Reimbursement or but related Revenue Cycle experience will be considered
  • A minimum of three to five years prior supervisory experience in medical billing and collections preferred

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