Manager Reimbursement - MedStar Transport Services Job Listing at MedStar Health in Columbia, MD (Job ID 155666)

Description

About the Job

General Summary of Position
Under the supervision of the Senior Revenue Cycle Manager directs the daily activities of the Reimbursement Department manages all aspects of the revenue cycle including Coding Claim Submission Cash Posting and Accounts Receivable. Provides expert information regarding reimbursement to all staff. This role is a vital position in the revenue cycle process for MedSTAR Transport services.

Primary Duties and Responsibilities

• Assists in the selection training orienting and assisting department staff. Develops standards of performance evaluates performance and conducts performance management planning. Initiates or makes recommendations for personnel actions. Maintains ongoing communication with subordinates to review programs provide feedback discuss new developments and exchange information.
• Implements controls to ensure appropriate submission billing and payment cycles. Establishes appropriate procedures for follow-up on third party approvals billing and collection on overdue accounts.
• Ensures compliance with regulations and billing and collections policies in order to facilitate attainment of accounts receivable (AR) targets.
• Performs ongoing trend analysis on third party payer payment levels to ensure that reimbursement is in accordance with allowable amounts stated in agreements and contracts. Works with appropriate individuals to resolve discrepancies.
• Performs ongoing trend analysis of third party payer rejects and denials. Develops training programs for registration billing and coding staff to eliminate/reduce rejects/denials.
• Monitors and makes decisions regarding the value and collectability of accounts receivable. Makes recommendations and procedures to keep Days of Revenue in AR at acceptable levels. Prepares monthly analysis and reports pertaining to AR. Keeps department management aware of all consistent or significant billing discrepancies.
• Implements and monitors collection procedures minimizing contractual and bad debt write offs and maximizing cash collections.
• Performs detailed audit(s) of patient bills in comparison with patient medical records and other documentation for accuracy of coding appropriate clinical indication and level of reimbursement identifying previously unbilled or undocumented charges as well as undercharges. Analyzes consistent billing discrepancies utilizing all available information in order to determine possible causes of errors and to identify potential solutions. Instructs medical staff on appropriate charting and documentation to ensure optimized reimbursement and adherence to compliance standards.
• Provides reimbursement expertise for the administration staff reimbursement staff and technical staff. Maintains current in own knowledge/competencies of reimbursement(s) including but not limited to: CPT coding ICD-10 codes HIPPA and applicable regulatory environment and works to ensure that the reimbursement system is so optimized. Maintains current written information about departmental billing practices and charges and keeps others members of the department informed.

Minimal Qualifications
Education

• High School Diploma or GED required 
• Bachelor's degree preferred
• One year of relevant education may be substituted for one year of required work experience.

Experience

• 5-7 years Experience in medical billing reimbursement required 
• 3-4 years Prior supervisory experience preferred

Licenses and Certifications

• Certified Professional Coder (CPC) preferred 
• Certified Ambulance Coder (CAC) within 1 Year required 
• Certified Ambulance Compliance Officer (CACO) within 1 Year required 
• Certified Ambulance Privacy Officer (CAPO) within 1 Year preferred

Knowledge Skills and Abilities

• Excellent verbal and written communication skills.
• Ability to perform basic arithmetic calculations.
• Excellent ability to communicate with patients their relatives physicians and a variety of Agency personnel.
• Working knowledge of Windows operating systems.
• Demonstrated ability to handle multiple tasks concurrently.
• Demonstrated ability to plan organize and prioritize work responsibilities.
• Basic computer skills preferred. Knowledge of pertinent Federal State and local laws codes and regulations related to patient billing and collection. Working knowledge of insurance collections.
• Ability to supervise a staff.