US Anesthesia Partners

  • Manager - Reimbursement

    Metro Area Orlando, FL
    Job ID
    2018-2284
    Location
    US-FL-Maitland
    Function
    Revenue Cycle Management
    Employment Status
    Full-Time
  • 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. 

     

    The Reimbursement Manager is responsible for verifying the contracted payment rates received by USAP from commercial and federal payers for the services that USAP physicians, CRNA’s or other providers perform are reimbursed at the appropriate payer contracted rate. The manager and applicable team will appeal any variances to minimize inappropriate payments. The team will work with internal stakeholders to have all payments/refunds/adjustments processed and ensure compliance regulatory timeframes and in accordance with contract terms and policies. Supports the success of a high-performing shared services organization by helping to champion and drive the long-term vision. Helps foster an environment in which continuous improvement in business processes and services is welcomed and recognized. Participates in programs and in using tools in support of building a high-performance culture.

    Responsibilities

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

    • Oversee day to day operations of claims and payer reimbursement variances
    • Provide detailed monitoring and analysis of the Payer Contract Management System.
    • Manage and monitor active inventories, monitor staff work assignments and productivity, 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 Lead to enhance billing system term logic
    • Partners with Payer Relations Lead and RCM Operational Management team 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 Lead 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 Lead 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 Reimbursement Team.
    • 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

    EDUCATION/TRAINING/EXPERIENCE:

    • Bachelor’s degree in a business or health related field highly required; Masters degree 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

     

     

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed

    Need help finding the right job?

    We can recommend jobs specifically for you! Click here to get started.