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!
Pharmaceutical distribution company Mediq (formerly OPG Groep) is involved in both commercial wholesaling and consumer retailing of drugs...