Reimbursement Manager
Walgreens - San Antonio, TX

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Job Duties Include: Manage all aspects of the intake/reimbursement department including the timely, accurate submission and collection of all patient and customer accounts. Meet cash, AR and DSO goals as established by corporate. Keep the unbilled at or below Walgreens parameters.Works with the intake and/or reimbursement department in order to manage the entire process from insurance verification to final collection. Schedules all billing functions appropriately. Responsible for the timely accurate submission of all claims for service to the responsible payer. Maintains the unbilled at appropriate levels for type and mix of business.

Ensures that insurance coverage is verified, initial prior authorization is received and patient demographic and insurance information is entered into the system. Accepts referrals based on Walgreens scope of service and current contracts. Ensures the appropriate notification of patients in regards to their financial responsibility. Ensures that all payers are set up correctly within the software system. Monitors and validates adherence to Policies and Procedures, auditing as necessary. Monitors and evaluates employee productivity and performance to goal. Completes all required projects and reports in a timely fashion on a daily, weekly or monthly basis per the direction of region or corporate management.

Develops, monitors, coaches and manages staff, ensuring the development of employees through orientation, training establishing objectives, communication of rules, constructive discipline. Builds employee morale, motivation and loyalty and fosters a team-like environment.

Minimum Requirements:
  • Bachelor’s degree and at least 3 years of healthcare intake/admissions and/or reimbursement experience OR a high school diploma and at least 5 years of healthcare intake/admissions and/or reimbursement experience.

  • At least 1 year of experience directly managing people including hiring, developing, motivating, and directing people as they work.

  • Experience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems.

  • Experience collaborating with internal resources to develop strategies that meet department goals within budget and established timelines.

  • Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling).

  • Intermediate level skill in Microsoft Word (for example: inserting headers, page breaks, page numbers and tables and/or adjusting table columns).

  • Intermediate level skill in Microsoft PowerPoint (for example: applying a theme, formatting character spacing, inserting a picture, changing slide layout and theme colors, adding transitions, customizing slide numbers, changing chart style and/or formatting font).

Preferred Qualifications:
  • Bachelor’s degree in Healthcare Administration or Business-related field.

  • Previous Infusion Medical Billing/Collections or Intake/Admissions experience.

  • At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines.

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