Manager, Priority Claims Services

• Lead with recruiting, training and retention of qualified Specialists and Analysts. Ensure that applicable training materials are comprehensive and complete. Conduct training of relevant personnel as needed and interface with company training resources.
• Maintain understanding of reimbursement issues and disseminate best practices with other staff members.
• As coding, coverage and reimbursement can change, candidate must be flexible and able to adapt to customer needs, as well as overall reimbursement requirements as determined by the strategic direction within the department.
• Maintain expertise in healthcare policy issues nationally, regionally, and locally.
• Provide ongoing direction to Specialists and Analysts. Coordinate communications with Directors of Operations, AAM’s and RVP’s.
• Review and introduce new and existing tools that will effectively improve work processes and outcomes. Conduct analysis of existing processes and propose process improvements.
• Enforce Compliance with regulatory requirements and Company Policies. Perform independent audits of responses submitted as well as received.
• Enforce compliance with HIPAA Privacy Rules to ensure the privacy and security of protected health information.
• Perform all employee management actions including hiring and training of new staff, coaching and development of staff and providing corrective action guidance including full discipline processes for staff.’

Minimum

• Bachelor’s degree in Healthcare Administration, Business Administration or an ancillary medical field and 5 years of experience - OR - an equivalent combination of education/experience
• Experience must include:
  • Five years’ experience in healthcare reimbursement and/or five years’ experience in patient care center administration required
  • Five years’ experience in Medicare reimbursement and knowledge of Medicare Policies.
  • Two years supervisory experience.
• Required to be proficient in Windows based office technologies (ex. Word, Excel).

Preferred

• Master’s degree in Healthcare Administration, Business Administration or an ancillary medical field is preferred.
• Eight years’ experience in healthcare reimbursement and/or eight years’ experience in patient care center administration required is preferred.
• Eight years’ experience in Medicare reimbursement and knowledge of Medicare Policies.
• Five years supervisory experience is preferred.
• Supervising/managing experience in a multi-site environment is preferred.

• Strong interpersonal skills and supervisory skills.
• Strong understanding of financial and accounting practices.
• Able to research, review and comprehend payer policies and reimbursement requirements.
• Competent knowledge of orthotics and/or prosthetics patient care administration.
• Act with integrity in all ways and at all times, remaining honest, transparent, and respectful in all relationships.
• Keep the patient at the center of everything that you do, building lifelong trust.
• Foster open collaboration and constructive dialogue with everyone around you.
• Continuously innovate new solutions, influencing and responding to change.
• Focus on superior outcomes, and calibrate work processes for outstanding results.

• Competitive Pay
• Health Insurance
• Dental Insurance
• Vision Insurance
• 8 Paid Holidays per Year
• Paid Vacation Time Off
• Paid Sick Time Off
• 8 hours of paid time to volunteer in your community
• Floating Holiday
• Life Insurance
• Medical Flex Spend Account
• Dependent Care Flex Spend Account
• Free employee assistance program
• 401(k)
• Full-time employees are also eligible for short-term and long-term disability insurance