Reimbursement Services Director jobs in San Bernardino, CA

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)

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Consumer Services Reimbursement Specialist I - Purchase of Service
  • Opportunities
  • San Bernardino, CA FULL_TIME
  • SUMMARY: 

    Under general supervision of Administrative Unit Manager - Purchase of Service perform fiscal clerical work in connection with the examination, calculation, reconciliation and recording of accounts payable records, verify check claims for payment, process requests to authorize payments; verify records for accuracy and completeness; and prepare summary reports. Perform related work as required.

    HOURLY RANGE:

    • $23.1037 - $32.5092 per hour 

    SIGN-ON BONUS!

    • $250 sign-on bonus after the completion of 90 days of employment at IRC with work performance in good standing.
    • $500 sign-on bonus after the completion of 6 months of employment at IRC with work performance in good standing.
    • Make sure to tell us if an IRC employee referred you when you get to that question on your application! Please include their full name.

    GENEROUS BENEFITS PACKAGE AND EMPLOYEE PERKS:

    • To view our benefits package and employee perks, please click HERE . 

    ESSENTIAL DUTIES AND RESPONSIBILITIES:

    • Examine vendor paper and electronic invoices daily for accuracy and completeness.
    • Prepare, verify changes and key enter accounts payable (A/P) input within scheduled time frames.
    • Accurately calculate payment from vendorized rates, Schedule of Maximum Allowance (SMA), Current Procedural Terminology (CPT) or negotiated rate, and/or bill for third party payments, proportionate cost, and absences. Substantiate amount, source, and distribution of consumer revenue.
    • Investigate on-line edits, warning, errors and resolve according to agency procedures/policy.
    • Key enters payment data to generate checks. Prepare and mail checks. Post and record financial transactions. Print invoice screen indicating potential loan; verify validity with Revenue Consumer Unit (RCU) and confer with manager on course of action.
    • Receive and examine service authorization requests weekly for compliant approval level, validity of services, and completion of required information e.g. license, insurance, cardiopulmonary resuscitation CPR. 
    • Verify level of supervision with rate tools; verify source of fund (SOF) information, payee status, and ensure SOF amounts cover basic cost of care. Record and bill third party payors as assigned.
    • Investigate and resolve discrepancies between service request and vendor, consumer or SOF information.
    • Examine and process authorization requests within 15 calendar days of receipt daily. Select correct rate subcode, service type, service code, and authorization setup.
    • Indicate special processing requirements. Notify staff or public of missing or incomplete documents and/or logs and return unacceptable documents within one day of receipt. 
    • Confirm monthly consumer benefit expected or currently being received by consumer.
    • Key enters data to generate accurate authorization on a timely basis. Type request data card as required.  Post and record financial transactions. 
    • Encumber/disencumber funds and modify authorization setup based on new or changed authorizations, rates, payments, or terminations.
    • Request edit reports and reconcile input document with edit, make correcting entries as needed and verify control totals.
    • Prepare and mail authorization and invoice documents at scheduled times.
    • Post encumbrances from authorization entry.
    • Process release of conserved consumer funds (ICRC 106) according to established time frames.
    • Examine request for validity and disbursement approval.
    • Set pay date according to established pay schedule.
    • Create and edit pay batch for entry and/or address errors.
    • Investigate ICRC 106's rejected due to insufficient funds.
    • Notify RCU promptly when unable to process because of insufficient funds. Correct and reenter when applicable.
    • Serve as resource to agency staff and service vendors daily. Assist employees in finding information or materials as assigned. Handle complaints and resolve discrepancies in payments and authorizations. Explain billing requirements and assist vendors in following procedures for billing and payment on a timely basis. Explain or interpret billing unit policy and procedures to employees, public or officials. 
    • Maintain log and verify number of checks issued. Identify, stamp and void checks by making adjusting entries to fiscal records and complete required documents.
    • Distribute checks, payment register, certification statements, authorization tickler and other appropriate documents on schedule.
    • Compile monthly and periodic reports such as summaries of projected encumbrances by budget code, category, and fiscal year.
    • Compose and type correspondence to vendors to recover overpayments and about services not authorized.
    • Send standard letter in response to routine request. Send standard letter requesting invoice or notice that services were not provided. 
    • Assist manager in documenting procedures and writing instructions. Develop, adapt, or select most appropriate procedure to carry out directives. 
    • On a daily basis maintain an adequate skill level in interpersonal and community relationships.
    • Comply with agency Personnel Policies and Procedures, and Affirmative Action Plan.
    • Maintain good attendance and punctuality.
    • Key enters data into IBM AS400.
    • Prepare and distribute necessary reports on a timely basis.
    • Keep manager informed of pending work, work in progress and problems encountered.
    • Update knowledge through reading, briefings, and training.
    • Drive vehicle/travel to other offices/locations to pick up, deliver materials.
    • Organize travel effectively and efficiently. Maintain a safe driving record.
    • Utilize agency’s IT systems as assigned, maintain security and following agency’s protocol and procedures, rules, and requirements. Use equipment appropriately and keep it in good repair. Keep work area neat and orderly.  Observe all safety rules.
    • Comply with the administrative requirements of the agency on a daily basis. Work cooperatively and effectively with others. Perform as a member of the team, answer questions, share expertise and contribute to the harmony of the team. Handle change well and be flexible and adaptable in dealing with interruptions, new priorities, and new assignments.
    • As needed or assigned, screen and distribute incoming unit mail.
    • Perform different or additional work as needed or assigned. Perform unit assignments on rotation basis or as assigned.

    MINIMUM POSITION REQUIREMENTS:

    • High school diploma or equivalent. Twenty-four (24) months of clerical accounting work to include 18 months A/P and one year heavy key entry and EDP file maintenance. A Bachelor’s degree in Business or Accounting may be considered in lieu of work experience. 
    • Knowledge of bookkeeping and accounting terminology practices and procedures.
    • Knowledge of office practices and procedures.
    • Knowledge of electronic data processing as it relates to accounting.
    • Ability to reconcile differences within the record keeping system requiring an understanding of the relationships among accounting records and documents.
    • Ability to maintain ledgers and to prepare statistical summaries and reports.
    • Ability to use ten key/calculator proficiently.
    • Ability to read and interpret governmental regulations. Ability to establish and maintain effective working relationships with others. Ability to work cooperatively and effectively with others. Perform as a member of a team, answering questions, sharing expertise, and generally contributing to the harmony of the team.
    • Ability to handle change well and be flexible and adaptable in dealing with interruptions, new priorities, and new assignments. Ability to follow oral and written direction. Good verbal and written communication skills.
    • Demonstrate ability to type accurately 35 wpm.
    • Assure that consumer rights and dignity are maintained in the provision of services.
    • Full use of an automobile, possession of a valid California driver's license and liability insurance for the minimum amount prescribed by law or ability to provide for independent transportation. Must have and maintain a safe driving record.

      We are proud to be an EEO employer. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

    • 8 Days Ago

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    Director of Nursing Services - California
    • Rockport Healthcare Services
    • Palm Springs, CA FULL_TIME
    • Position Description: Under the direction of the Administrator, the Director of Nursing Services is responsible for the administration and management of Nursing Services to residents in accordance wit...
    • 6 Days Ago

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    Director of Surgical Services
    • San Gorgonio Memorial Hospital
    • Banning, CA FULL_TIME
    • POSITION SUMMARY: The Director of Surgical Services directs and coordinates the nursing care given and all aspects of management for the Surgical Services department. This includes the Operating Room,...
    • 14 Days Ago

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    Interim Director, Technology Services
    • San Bernardino Community College District
    • San Bernardino, CA FULL_TIME
    • Salary: $9,577.33 Monthly Location: District Office 550 E. Hospitality Lane Suite 200 San Bernardino, CA Job Type: Department: Computing Services Job Number: 0663 Closing: 5/19/2022 4:30 PM Pacific Jo...
    • 15 Days Ago

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    Director Emergency Services RN
    • Providence
    • Apple Valley, CA FULL_TIME
    • Description THE ROLE Under general direction of the CNO and in collaboration with the Medical Director, the Director Nursing works with the nursing leadership team to plan, organize, staff, direct, co...
    • 4 Days Ago

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    Director Emergency Services RN
    • Providence Health
    • Apple Valley, CA FULL_TIME
    • Description THE ROLE Under general direction of the CNO and in collaboration with the Medical Director, the Director Nursing works with the nursing leadership team to plan, organize, staff, direct, co...
    • 4 Days Ago

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    0 Reimbursement Services Director jobs found in San Bernardino, CA area

    T
    Director of Operations
    • Terry Staffing and Consulting
    • Ontario, CA
    • Job Description Job Description Our Company: Terry Staffing is partnering with a construction and maintenance company, s...
    • 4/19/2024 12:00:00 AM

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    Community Director - EX
    • FPI Management
    • San Bernardino, CA
    • Multifamily Property Management The Community Director (Exempt) is fully accountable for all day-to-day operations of a ...
    • 4/19/2024 12:00:00 AM

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    Director of Benefits
    • Heritage Grocers Group
    • Ontario, CA
    • At Heritage Grocers Group, LLC, how we work is defined by shared values that include absolute integrity, respect, and co...
    • 4/18/2024 12:00:00 AM

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    Director of Benefits
    • Heritage Grocers Group
    • Ontario, CA
    • At Heritage Grocers Group, LLC, how we work is defined by shared values that include absolute integrity, respect, and co...
    • 4/17/2024 12:00:00 AM

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    Director FP&A
    • Hiring Now!
    • Ontario, CA
    • Overview Working directly for the CFO, the Director of FP&A will drive company-wide business financial and operational e...
    • 4/17/2024 12:00:00 AM

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    Community Director - EX
    • Fpi Management
    • San Bernardino, CA
    • Multifamily Property Management The Community Director (Exempt) is fully accountable for all day-to-day operations of a ...
    • 4/17/2024 12:00:00 AM

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    Director of Scheduling
    • Pinner Construction Co., Inc.
    • Anaheim, CA
    • Company Description Pinner Construction Co., Inc. is a trusted and reputable construction company based in Anaheim, CA. ...
    • 4/17/2024 12:00:00 AM

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    Director of Scheduling
    • Pinner Construction Co. Inc.
    • Anaheim, CA
    • Company Description Pinner Construction Co., Inc. is a trusted and reputable construction company based in Anaheim, CA. ...
    • 4/16/2024 12:00:00 AM

    According to the United States Census Bureau, the city has a total area of 59.6 square miles (154 km2), of which 59.2 square miles (153 km2) is land and 0.4 square miles (1.0 km2), or 0.74%, is water. The city lies in the San Bernardino foothills and the eastern portion of the San Bernardino Valley, roughly 60 miles (97 km) east of Los Angeles. Some major geographical features of the city include the San Bernardino Mountains and the San Bernardino National Forest, in which the city's northernmost neighborhood, Arrowhead Springs, is located; the Cajon Pass adjacent to the northwest border; City...
    Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
    Income Estimation for Reimbursement Services Director jobs
    $159,059 to $226,503
    San Bernardino, California area prices
    were up 3.0% from a year ago

    Reimbursement Services Director in Albuquerque, NM
    The Manager will be responsible for either audit or reimbursement functions, and can be responsible for one of four primary roles – desk review/audit, reopenings/appeals, interim rate review/reimbursement or acceptance/finalization for all provider types as both a preparer and reviewer of work product.
    December 27, 2019
    Reimbursement Services Director in Little Rock, AR
    The Manager assigns annual workload budget, distributes assignments to the team, ensures timely and accurate completion and review of all work, and makes final reimbursement determinations for all work assigned to the team.
    February 24, 2020
    Reimbursement Services Director in Las Vegas, NV
    The Director of Reimbursement will consistently improve processes and develop their teams to exceed established KPIs and raise collection revenue, while lowering the overall cost to deliver these services.
    January 05, 2020