What are the responsibilities and job description for the Manager, Reimbursement - Corporate Reimbursement/Coding - Full Time position at Guthrie Healthcare?
Position Summary:
Responsible for managing and coordinating activities of the Reimbursement Department. Responsible for working with CBO, operations, providers, and administration to support reimbursement activities including: staff development, develop and maintain policies and procedures. Analyze and identifies areas of opportunities in coding trends, rejections, and complex reimbursement issues and to team with appropriate parties to support resolution to maximize reimbursement.
Education, License & Cert:
Associate degree required. This requirement may be satisfied through an equivalent combination of education and three to five years in the health care industry. Certified in coding required.
Experience:
Minimum of two years supervisory or management experience preferred. Must have working knowledge of Medicare/Medicaid and Third‐Party Insurance reimbursement experience.
Essential Functions:
1. Responsible for managing and coordinating the activities of Reimbursement liaisons.
2. Provide ongoing staff development related to coding training and education.
3. Assist Director, Reimbursement with coordinating activities of Reimbursement Dept.
4. Prioritizes and assigns work to appropriate staff and ensures completion. Coordinates PTO coverage.
5. Analyzes and identifies reimbursement opportunities; recommends and implements methods for improvement.
6. Work closely with Director, Reimbursement to establish and coordinate a formal coding training program for employees and physicians.
7. Demonstrates skill and proficiency in analyzing and troubleshooting complex reimbursement problems.
8. Utilizing coding skills prepares and follows up with complex reimbursement issues for resolution and/or trains and assists staff in achieving this.
9. Maintains comprehensive knowledge and complies with billing guidelines for federal, state, and third‐party payer contracts.
10. Responsible for development and creation of policies and procedures.
11. Responsible for Human Resource activities, including recruiting, interviewing, hiring, performance appraisals, development plans and disciplinary actions. Provides ongoing performance feedback.
Other Duties:
1. Creates and maintains a supportive team environment and serves as a role model to keep the department focused on processes that result in maximized reimbursement.
2. Maintains strict confidentiality relating to patient health information in accordance with HIPAA compliance.
3. Participates in professional development efforts to ensure current with health care practices and trends.
4. It is understood that this description is not intended to be all‐inclusive and that other duties may be assigned as necessary in the performance of this position.
