We are currently looking for a Reimbursement Director in our Downers Grove, IL office!
• Responsible for managing all functions related to document collections, benefit verification and authorizations, as well as medical records associated with electronic data warehouse
• Develop expert team in benefit verification, documentation and payer authorization procurement
• Achieve daily and monthly credit review(verification/documentation/authorizations) goals
• Insure teams are well trained on contracts, payer rules and company revenue goals
• Create a flexible employee group that allows for shift in personnel hours to adjust to order volume
• Standardization of policy and procedures across all credit review teams
• Insure teams consistently meet acceptable service levels for releasing orders for shipment and follow up on pending orders.
• Monitors verification & documentation payer calls to review and improve employee’s telephone etiquette, technical accuracy, and conformity to the company’s standards.
• Analyze, evaluate and develop efficient work procedures and process improvements specifically focused around strategic objectives.
• Review key indicators on a monthly basis to evaluate results, areas of opportunity, staffing levels and to determine necessary action plans.
• Responsible for managing and executing key strategic projects and objectives within the reimbursement department(i.e. - expense savings, technology enhancements, write off reductions, compliance changes)
• Develops department and employee goals to achieve desired results
• Facilitates all necessary requirements for hiring staff, including internal job postings, creating advertisements, conducting interviews, coordinating pre-employment testing, etc., as needed
• Establishes and maintains relationships with government payers, as well as other payers, as needed
• Maintains knowledge of and educates staff regarding Medicare Part B and Medicaid(various states) guidelines, including all updates and bulletins
• Informs staff of all applicable company changes and information
• Demonstrates high standards of professionalism and work ethics.
• Recommends corrective action to rectify service issues and customer complaints.
• Creates a focused and enthused environment through motivation techniques, goal setting, seminars, incentive programs, etc
• Maintains harmony among workers and resolve grievances
• Responsible for 50+ employees with 3 supervisors as direct reports
• Bachelor’s degree from a four college or university; or ten years related experience and/or training; or equivalent combination of education and experience.
• Five years management experience.
• Minimum 3 years experience working closely with senior management
• Project management experience.
• Strong analytical skills required.
• Expertise of home medical supplies claims processing for Medicare, Medicaid, Insurance, and managed care.
• Strong knowledge of Medicare and Medicaid guidelines.
• Five years recruiting and training reimbursement/billing employees.
• Strong background of medical terminology.
• Well developed communication skills including verbal and written.
• Proficient in Microsoft Office software, including Excel, and Word. Familiarity with PowerPoint beneficial.
• Accustomed to utilizing Outlook to manage schedule
• Accustomed to integrating high volume of email communication into daily responsibilities
Byram offers a busy competitive environment and promotes from within. Employees play a pro-active role in our success. We offer training, a comprehensive benefits package including medical, dental, 401K with a match and tuition reimbursement. If you feel you meet the above requirements, please submit your resume. EOE. No phone calls please!
Byram Healthcare - 2 years ago
Pharmaceutical distribution company Mediq (formerly OPG Groep) is involved in both commercial wholesaling and consumer retailing of drugs...