Reimbursement Services Director - Home Care directs and supervises the activities of the benefits claims and provider reimbursement personnel in a home care environment. Sets procedures for filing reimbursement claims and ensures timely and accurate claims payments. Being a Reimbursement Services Director - Home Care monitors, evaluates and reviews all cost reporting in support of reimbursement claims. Produces the documentation necessary for reimbursement, Medicare Compliance, and control of receivables. Additionally, Reimbursement Services Director - Home Care may require an advanced degree. Typically reports to top management. The Reimbursement Services Director - Home Care 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 - Home Care typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
This is a remote position. This is for the Managed Care team.
The working hours are Monday-Friday, 8:00am -4:30pm, EST or CST.
Summary: The Insurance Reimbursement Specialist, under the direction of Accounts Receivable Manager, ensures claims submitted to responsible entities are received, processed, and resolved in a timely manner. This position’s goals are met through professional communication, confidentiality and adherence to HIPAA guidelines, and a working knowledge of CMS/other payer guidelines.
Essential Duties and Responsibilities: (List in order of importance or percentage of time spent on the particular responsibility. High to Low)
Qualifications:
Required Education: High school diploma or equivalent
Required Experience: 1 year of experience in healthcare revenue cycle or business office.
Required License/Registration/Certification: None
Reasoning Ability:
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables. Use reasoning to meet and maintain department and personal benchmarks.
Computer Skills:
To perform this job successfully, an individual should have knowledge of Word Processing software, spreadsheet software and database software.
Physical Demands:
In order to successfully perform this job, with or without a reasonable accommodation, the following are outlined below:
The Employee is required to read, review, prepare and analyze written data and figures, using a pc or similar and should possess visual acuity.
The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.
The Employee is not substantially exposed to adverse environmental conditions and therefore job functions are typically performed under conditions such as those found in general office or administrative work.