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 Specialist will be responsible for proper and timely posting of payments to patients accounts. This includes reviewing and analyzing electronic remittance, receiving payments, and interpreting payor contracts to determine appropriateness in reimbursement.
SUPERVISION RECEIVED: Revenue Cycle Management.
SUPERVISION EXERCISED: None
ESSENTIAL FUNCTIONS:
Critical to this position is a knowledge of billing and medical reimbursement procedures and ability to interpret electronic remittance/correspondence from insurance companies.
DUTIES AND RESPONSBILITIES:
QUALIFICIATIONS:
PHYSICAL/MENTAL DEMANDS:
ENVIRONMENTAL/WORKING CONDITIONS:
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities,
knowledge, skills, abilities and working conditions may change as needs evolve and to reflect the on-going changes in office.
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