This position is responsible for directing all technical and operational functions related to billing, claims processing and reimbursement methodology for all acute care facilities.
Essential Job Duties
Provides direction and oversight to the reimbursement team on contract, payer and/or regulatory changes and enhancements, overseeing the analysis, interpretation and loading of all reimbursement methodologies in either the contract management system or the payer responsibility masterfile (PRM)
Provides direct oversight of all changes and maintenance of profiles, master files, system tables, transaction codes that control reimbursement methods and systemic billing and collection activity as well as facilitation of related education, project leadership, process improvement initiatives, and technology enhancements
Demonstrates professional knowledge of regulatory compliance regarding billing and reimbursement regulations and practical experience applying accurate rules to processes to ensure compliance
Participates in and contributes to strategic management efforts to improve workflow, increase cash, reduce asset back defaults and avoid denials