Reimbursement Services Director jobs in Mississippi

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)

D
Area Director of Clinical Reimbursement
  • Diversicare of Tupelo, LLC
  • Tupelo, MS FULL_TIME
  • Overview

    Diversicare is a premier provider of post-acute care services to patients and residents at 43 skilled nursing and long-term care centers in five states. Together, with our team of dedicated healthcare professionals, we leverage our diverse strengths to provide each patient and resident with healthcare serves that best meet their needs.

    It is Diversicare’s Mission to “Improve every life we touch by providing exceptional healthcare and exceeding expectations.”

    Diversicare has an exciting opportunity for an Area Director of Clinical Reimbursement. In this role you will provide guidance and consultation of all aspects of the RAI process to assist facilities in meeting regulatory compliance. Additionally provide subject matter consultation on Medicare, Medicaid and Managed Care reimbursement and regulatory guidelines.

    Responsibilities

    The key role of the Director of Clinical Reimbursement is to ensure that the RAI process at each facility is being completed/coordinated in a timely and accurate manner that is in compliance with federal and state regulations. In addition to these responsibilities, the following expectations, which are not all-inclusive, will guide the Area DCR:

  • Train and consult with RNACs and LNACs on the RAI, Medicare, Medicaid and Managed Care processes to facilitate compliance, integrity and accurate reimbursement.
  • Train and consult with center staff and administration on the RAI, Medicare, Medicaid and Managed Care processes to facilitate compliance, integrity and accurate reimbursement.
  • Function as the subject matter expert for the regional team on the RAI, Medicare, Medicaid and Managed Care processes
  • Utilize Electronic Health Record and other available data systems to audit and monitor integrity of:
      • PDPM HIPPS modifier trends
      • RUG Trends in case mix states
      • ALOS
      • ADL Coding Accuracy
      • Overall RAI process
      • Identification and resolution of data integrity issues
      • Medicare, Medicaid and Managed Care program requirements
      • Medicare, Managed Care and Medicaid rates
  • Utilize Electronic Health Record and other available data systems to analyze and project Medicare, Managed Care, and Medicaid rates to facilitate accurate identification of provided services.
  • Review and analyze QM reports, investigate trends, and assist facilities in development and completion of plans to influence improvement.
  • Train and consult with centers on Medicare, Medicaid and Managed care Documentation Requests to ensure prompt response and corrective action.
  • Support Centers in retention and recruitment of MDS staff:
      • Complete second level interviews
      • Orient and provide ongoing training
      • Provide recommendations for performance assessment to administrator
  • Participate in Regional meetings and activities:
      • Quality Reviews
      • QAPI
  • Participate in Clinical Reimbursement Department Activities:
      • Program Development
      • Trainings
  • In the absence of a center NAC, Area DCR will provide direct center support which may include completion of tasks assigned to the NAC. This support may be onsite or remotely depending upon the need.
  • Other duties as assigned by leadership.
  • Qualifications

    1. Current RN license by State Board of Nursing.2. Minimum of 3 years’ experience as an MDSC.3. Prior experience in multi-facility consultation.4. Excellent communication skills; prior experience in teaching/training preferred.5. Computer skills necessary.6. Must obtain AANAC RAC-CT certification within 1 year of acceptance of position or Relias CMAC certification.

  • Just Posted

D
Mississippi First - Deputy Director
  • Deputy Director - Daniels Solutions
  • Jackson, MS FULL_TIME
  • About Mississippi FirstMississippi First was founded in 2008 by Rachel Canter and her childhood friend, Sanford Johnson. Driven to change the fact that Mississippi has historically been last, our foun...
  • 1 Month Ago

E
Reimbursement coordinator
  • Enhabit Home Health & Hospice
  • Hattiesburg, MS FULL_TIME
  • Overview Enhabit Home Health & Hospice is hiring a home health billing & collections specialist to join our team as a Reimbursement Coordinator. Reimbursement Coordinators are responsible for home hea...
  • Just Posted

E
Reimbursement coordinator
  • Enhabit Home Health & Hospice
  • Tupelo, MS FULL_TIME
  • Overview Enhabit Home Health & Hospice is hiring a home health billing & collections specialist to join our team as a Reimbursement Coordinator. Reimbursement Coordinators are responsible for home hea...
  • Just Posted

C
Director of Women's Services
  • Clinical Management Consultants
  • Oxford, MS FULL_TIME
  • An award-winning healthcare facility is looking for a skilled Nurse Leader to direct their Women and Children's Service Lines. This 372 bed facility takes care of a wide range of patients ranging from...
  • 16 Days Ago

P
Director of Social Services
  • Picayune Rehabilitation and Healthcare Center
  • Picayune, MS FULL_TIME
  • Nexion affiliates operate 56 skilled nursing and rehabilitation as well as assisted living facilities in Louisiana, Mississippi and Texas. Each of our affiliate skilled nursing and assisted living cam...
  • 18 Days Ago

B
Project Director
  • BluSky
  • Minnetonka, MN
  • BRIEF DESCRIPTION: The construction Project Director is responsible for managing and closing new business opportunities ...
  • 4/23/2024 12:00:00 AM

A
Agency Director
  • Ambercare
  • Clovis, NM
  • >> We offer our team the best << Medical, Dental and Vision Benefits Continued Education PTO Plan Retirement Planning Li...
  • 4/23/2024 12:00:00 AM

B
Project Director
  • BluSky
  • Norcross, GA
  • BRIEF DESCRIPTION: The construction Project Director is responsible for managing and closing new business opportunities ...
  • 4/23/2024 12:00:00 AM

U
Director of Operations
  • UHC Solutions
  • Los Angeles, CA
  • The Director of Clinic Operations is responsible for the overall planning, development, coordination, implementation and...
  • 4/21/2024 12:00:00 AM

S
Director, Clinic
  • Sanford Health
  • Alexandria, MN
  • Careers With Purpose Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the Unite...
  • 4/20/2024 12:00:00 AM

W
Director of Preconstruction
  • Wallick Communities
  • New Albany, OH
  • Description Wallick’s Construction team is currently seeking an experienced Construction professional for a Director of ...
  • 4/3/2024 12:00:00 AM

T
Director of Stewarding
  • The Newbury Boston
  • Boston, MA
  • Compensation Type: Yearly Highgate Hotels: Highgate is a premier real estate investment and hospitality management compa...
  • 4/1/2024 12:00:00 AM

L
Executive Director
  • Life Space Communities
  • Amarillo, TX
  • Community: The Craig Address: 5500 SW 9th Ave Amarillo, Texas 79106 Pay Range $139,900. 00-$202,912. 50+ Annual Live you...
  • 9/22/2023 12:00:00 AM

Mississippi is bordered to the north by Tennessee, to the east by Alabama, to the south by Louisiana and a narrow coast on the Gulf of Mexico; and to the west, across the Mississippi River, by Louisiana and Arkansas. In addition to its namesake, major rivers in Mississippi include the Big Black River, the Pearl River, the Yazoo River, the Pascagoula River, and the Tombigbee River. Major lakes include Ross Barnett Reservoir, Arkabutla Lake, Sardis Lake, and Grenada Lake with the largest lake being Sardis Lake. Mississippi is entirely composed of lowlands, the highest point being Woodall Mountai...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Services Director jobs
$134,357 to $191,326

Reimbursement Services Director in Huntington, NY
Mediware’s reimbursement team provides trusted home infusion and DME reimbursement services including complete outsourced billing and collections, consulting, due diligence services, and flexible collection project options.
February 13, 2020
Reimbursement Services Director in Salem, OR
Tuition Reimbursement Services, or Programs, are also referred to as Tuition Assistance Programs.
February 18, 2020
Reimbursement Services Director in Queens Village, NY
Manages the team member’s and workload of the Audit/Reimbursement unit to ensure compliance with the standards set forth by the Centers for Medicare and Medicaid Services (CMS).
December 17, 2019