We are a group of consultants with various fields of expertise within the medical technology/medical device industry. We assist/guide medtech companies in going to market (qms, fda, marketing, ..) we are looking for medical device reimbursement experts to work with us on projects wherein new medical device technologies are being introduced onto the usa market.+10 Other Responses
Medical Billing And Reimbursement
This full-time job post has been authorized by zintro.
Job position: director, billing & reimbursement
provides effective leadership and management of the reimbursement department in revenue management, medical insurance authorizations and managed care contracting.
Essential duties and responsibilities:
• develops, implements and manages the policy and procedures to ensure complete, accurate, and compliant processes that result in optimal collections and customer service performance for the organization.
• directs the complete revenue cycle process for reimbursement services: ensures timely authorization of tests; initiates prompt calls and manages and monitors contract status and compliance.
• is the key interface with xifin, our billing and collection service to ensure pricing is accurate and billing policies are followed.
• coaches, trains and mentors team to meet departmental goals.
• establishes performance metrics and reporting on progress to management on a weekly basis.
• identifies issues and opportunities within the reimbursement process and implements strategies to improve efficiency and effectiveness.
Knowledge, skills and abilities:
• third-party reimbursement, managed care organizations guidelines, medicaid & medicare regulation experience required, medical terminology experience preferred.
• ability to read, analyze and interpret documents, periodicals, professional journals, technical procedures and government regulations.
• strong financial, problem solving, and organizational skills.
• ability to read, interprets, and analyzes business and accounting documents.
• effective communication skills, the ability to provide clear and concise oral/ written information to internal/external customers.
• ability to maintain confidentiality and hipaa compliance practices.
• bs degree in business or a related field
• 8 years revenue cycle experience and 5 years in a leadership
role overseeing medical authorizations, managed care and reimbursement employees.
Candidate must be authorized to work in the u.S.A.+11 Other Responses
As far as i can see, in order for a provider to be reimbursed by medicare for issuing a dme, the claim must include a detailed written order. The detailed written order must contain five elements (name of doctor, name of beneficiary, date, description of item, signature of doctor) to be approved for reimbursement. My inquiry is as follows: can progress//chart notes (or other medical records) that contain all of the five aforementioned elements qualify as a detailed written order for medicare reimbursement purposes? There is no statutory or regulatory definition of a detailed written order, so is anything containing those five elements considered a detailed written order by the cms? Thank you for your assistance.+10 Other Responses
Behavioral Health Insurance Trends
We're looking at making an investment in a behavioral health billing firm. I would like to have one or more experts answer some questions about the industry and treatment center implications of insurance companies pushing treatment from out-of-network to in-network. Further, i'd like to discuss how that affects a billing company's value proposition moving forward.+28 Other Responses