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Billing Reimbursement Manager

Company: West Tennessee Healthcare
Location: Jackson
Posted on: February 13, 2020

Job Description:

Responsible for the planning, organization, and coordination for all referrals, scheduling, and reimbursement aspects at the Therapy & Learning Center. Responsible for performing and supervising insurance benefit and account specialist duties, general office duties for the department ensuring proper billing, scheduling, insurance verification, and timely re-verification. High School Education or GED equivalent required. Ability to manage and perform office procedures efficiently as required through a minimum of 3 to 4 years of experience in a medical or hospital billing/scheduling environment preferred. Under the direct supervision of the Director of the Therapy & Learning Center responsible for billing personnel supervision as well as specific duties to include processing referrals, scheduling, billing, claims processing, insurance verification, monthly reporting, chart review, maintenance of accuracy of patients medical records, basic accounting skills, good telephone etiquette, and good communication skills. Assures that insurance verification and scheduling is timely and accurate and per regulatory guidelines.Responsible for all scheduling and insurance verification procedures.Evaluate and recommend system changes to improve department operations to accomplish a higher degree of efficiency and to maximize effective utilization of resourcesContinually review, revise, and update procedures to assure efficient workflow between the Therapy & Learning Center personnel to HIM, Billing, and other departments.Maintains patient confidentiality as specified in the HIPPA and WTH Confidentiality Agreement.Assures and monitors compliance with guidelines as directed by regulatory agency guidelines.Responsible for the investigation of denials, compliance issues, and other problems associated with billing.Liaison to TennCare, TEIS, and other third party payor representatives.Interviews, trains, assign, monitor work, evaluate performance, counsels, and educate departmental personnel.Is the designated superuser of all computer-based billing and scheduling software and responsible for remaining current regarding changes/upgrades of software systems.Responsible for training staff on computer-based programs.Monitors payer certifications and re-certifications and distributes to proper personnel for completion.Maintains current orders from primary care providers for all services.Coordinates the provision of interpretation services as needed inpatient scheduling and clinical intervention.Ensures that all financial information is scanned and maintained including referral information, orders, insurance authorizations, financial forms, insurance cards, HIPPA authorizations, etc. into the computer system.Prepares discharged charts to be sent to HIM, and properly cancels/discharges accounts from the patient registration system. Sends log of canceled/discharged accounts to HIM.Must be thorough and accurate when entering patient demographic information and insurance information.Keeps Therapy Services Manager and Director informed on possible problem areas thus taking care of the situations before they become major problems.Responsible for duties of the Insurance Benefits Specialist and Patient Account Specialists in their absence.Contributes to a positive work climate and the overall team effort of the department and hospital, perform any related responsibility as required or directed and greet guests by our Guest Excellence principles.Performs related responsibilities as required or directed.EDUCATION: High School Education or GED equivalent required. Skills and proficiency in the principles, concepts, and techniques of therapy billing, documentation, and regulatory guidelines.Ability to comprehend and interpret policies and regulations.Familiarity with Medicare/TennCare and private insurance regulations.Ability to use a computer, word processing, AS400 including billing software and registration procedures, PHS, and Power Chart.LICENSURE, REGISTRATION, CERTIFICATION:NAEXPERIENCE:Ability to understand, spell, and use medical terminology especially Rehabilitation terminology. Knowledge of hospital and department policies and procedures as acquired through 2-3 months of orientation. Two to three years of experience in billing and reimbursement in the healthcare field.Some management experience preferred.Requisition ID: 2020-39509 Shift: Days Street: 32 Garland Drive Post End Date: 2/9/2020 *F-Location Name w/o External ID: Therapy and Learning Center *F-Location Name w/o External ID: TLC - Clinic Based Therapy

Keywords: West Tennessee Healthcare, Jackson , Billing Reimbursement Manager, Accounting, Auditing , Jackson, Tennessee

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