Local Reimbursement Director GENERAL SUMMARY: The Local Reimbursement Director serves as the primary contact between assigned Practices and the Central Billing Office (CBO) for all aspects of the billing and collection of professional services. Working closely with the Director of Revenue Cycle, the Local Reimbursement Director is responsible for the proactive management of the client. Management of the relationship requires full assessment and understanding of the department’s revenue cycle, including a thorough understanding of systems, processes and service specific coding and billing requirements, proactive identification of opportunities for revenue cycle improvement initiatives, and development of plans to implement process improvements. The Local Reimbursement Director will proactively identify issues and opportunities for improvement as well as follow-up on department concerns. PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:
- Establishes and manages effective ongoing communication with assigned Practices including Physicians to identify and address business needs.
- Provides assessment, analysis and proposes solutions for performance and budgetary questions.
- Effectively manages group or practices expectations regarding financial performances. Assists department with statistical analysis and reporting.
- Analyzes the implication of each element in the revenue cycle communicating, interpreting and developing interventions and initiating actions.
- Focuses Practices on issues that will positively impact financial performance. Works with Practice leadership on annual budgeting, forecasting and analysis for potential new business opportunities.
- Supports the integration of new physicians/departments into CBO.
- Represents functional areas within CBO collaborative areas of Practice billing team.
- Develops standardize approaches for operational issues, reporting, analysis and quality management.
KNOWLEDGE AND SKILLS REQUIRED:
- Must be skilled in project management, data analysis and trending, performance measurement and problem solving as well as have a solid background in physician billing and collections.
- Must have strong presentation skills and the ability to present to multiple constituents including VP’s, Practice Directors, Physicians and staff.
- Working knowledge of CPT and ICD9-10 coding and claims processing required.
- Must be proficient with Microsoft Suite of Office Applications including Word, and PowerPoint.
- Proficiency in Excel required, Access preferred.
- Proficiency in Data Warehouses required.
- Requires a familiarity with a major professional billing system.
- Requires strong facilitation skills.
- Proven ability to problem solve and participate as a productive team member is critical.
- Requires the ability to juggle multiple projects and issues at the same time.
KNOWLEDGE AND SKILLS PREFERRED:
EDUCATION AND EXPERIENCE REQUIRED:
- High School graduate/equivalent with 8years progressive experience in medical billing, or
Bachelor’s degree in business related major (e.g. general business management, accounting, finance or similar field) with 2 years’ experience in medical billing, or Master’s degree in business, finance or healthcare. EDUCATION AND EXPERIENCE PREFERRED:
- Master’s degree in business, finance or healthcare