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)
Work Status Details : Management | 80.00 Hours Every Two Weeks
Exempt from Overtime : Exempt
Shift Details : Varies based upon department/organizational needs
Department : Patient Financial Services Admin | Reports To: VP Finance
The mission of Faith Regional Health Services is to serve Christ by providing all people with exemplary medical services in an environment of love and care.
Summary:
The Director is responsible for all functions of the department. Plans, directs, coordinates, evaluates, and requires a sound knowledge of the overall Patient Financial Services, Registration, Central Scheduling, Communications, and Interpreters Departments. Promotes safety and well-being of all patients and/or staff in the assigned department(s) on a twenty-four hour basis. The Director will have demonstrable skills in leadership, management, interpersonal relations, conflict resolution, and problem solving.
The functions of the Director include: financial management of the department including budget development and ongoing evaluation; management of human resources; responsibilities and duties as a member of a multi-disciplinary team; leadership as a mentor for staff members; strategic planning; day to day operations; procurement and maintenance of supplies and equipment, including purchasing capital equipment; contract maintenance; maintaining and developing hospital policies and procedures; identifying and implementing performance improvement initiatives and evaluation effectiveness; maintain departmental regulatory compliance; developing and implementing a patient/customer focused staffing plan. The Director participates in, or delegates appropriate participation in all performance improvement teams, medical staff committees and work teams.
The listing of job duties contained in this job description is not all inclusive. Duties may be added or subtracted at any time due to the needs of the organization.
Responsibilities:
Essential Job Duties and Responsibilities:
1. Performs duties and responsibilities according to job description and VP's direction, following department policies and procedures with the knowledge and understanding of the difference in effective, tactful interaction required for a patient or client as compared to an employee.
Essential Management/Leadership Duties and Responsibilities:
1. Accomplishes department objectives by managing staff; planning and evaluating department activities.
2. Organizes and oversees the staff by recruiting, selecting, orienting, and training employees. Coaches, counsels, and disciplines employees.
3. Accomplishes staff results by communicating job expectations, planning, monitoring, and appraising job results. Conducts performance evaluations that are timely and constructive.
4. Ensures a safe, secure, and legal work environment.
5. Contributes to team effort by accomplishing related results as needed.
6. Develops, coordinates, and enforces systems, policies, procedures, and productivity standards that will improve day-to-day operations.
7. Establishes strategic goals by gathering pertinent business, financial, service, and operations information.
8. Defines objectives, identifies and evaluates trends and options, chooses a course of action, and evaluates outcomes.
9. Accomplishes financial objectives by forecasting requirements, preparing an annual budget, scheduling expenditures, analyzing variances, and initiating corrective financial actions.
10. Develops personal growth opportunities.
11. Maintains quality service by enforcing quality and customer service standards, analyzing and resolving quality and customer service problems, and recommending improvements.
12. Projects a positive image of the organization to employees, patients, customers, and the community.
13. Using Hardwiring for Excellence tools and techniques; Leadership Evaluation Management (LEM); My Rounding.
Hours will be dependent on patient census and workload. Ability and willingness to work a flexible schedule, to include after-hours and weekends as necessary.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Other information:
Job Requirements:
The requirements listed below must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required.
EDUCATION:
Bachelor’s Degree required.
EDUCATION FIELD OF STUDY:
Business Administration, Accounting or related discipline required.
Previous Experience Requirements:
EXPERIENCE:
5 years of experience in management/organization required.
Previous healthcare accounts receivable experience preferred.
Skills/Knowledge Requirements:
SKILLS:
Language Skills – Ability to read, write, speak, and understand the English language required.
Strong analytical capabilities preferred.
Faith Regional Health Services is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
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