Medical Billing And Reimbursement
This full-time job post has been authorized by zintro.
Job position: director, billing & reimbursement
position summary:
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.
Education/experience:
• 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 ResponsesMedical Billing And Coding
Medical billing and coding
determine whether mental health crisis services have been appropriately submitted for medicaid reimbursement.
+2 Other ResponsesDme Reimbursement
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 ResponsesHealth Plan Reimbursement
We are interested in connecting with individuals who are familiar with:
health plan reimbursements
value based care
we need to speak to individuals at:
healthcare providers (stand-alone hospital, healthcare system, idn, physician practice group, etc.)
or
providers of health plan
the ideal experts will have the following titles:
chief medical officer
chief medical information officer
chief information officer
other c-level (e.G., ceo, coo, cfo, etc.)
president or general manager
vice president
director
manager
ideal experts will need to be either decision makers or influencers for 1 of the following functions:
a. Supporting or developing our value-based reimbursement capabilities
b. Selecting new systems, technology, or third party solutions to improve the quality of patient care
c. Selecting new systems, technology, or third party solutions to improve the ability to manage reimbursement-related risks
d. Selecting new systems, technology, or third party solutions to improve the cost-efficiency of operations
e. Selecting new systems, technology, or third party solutions to improve overall competitiveness in a value-based reimbursement environment
they must be working in the following departments/functional areas:
general management
finance or accounting
information technology
health services
patient care or care coordination
value-based care
payment, reimbursement, or value-based reimbursement
patient engagement
operations
healthcare analytics or predictive modeling
clinical informatics
strategy
+28 Other ResponsesDigital Pathology Reimbursement
We are a us based investment firm that is currently researching digital pathology. Ideally, we are looking to speak with an expert in digital pathology with particular experience in pathology labs and reimbursements that could tell us how a new technology might fit into the current reimbursement model. This is an urgent need and so the call will likely take place in the next few days.
This would be someone who runs an anatomic pathology lab at an independent lab or as part of companies like labcorp or quest diagnostics. Only us based. You should have knowledge of digital pathology and the procurement and reimbursement of new computer aided diagnosis technology. And specifically, knowledge of cpt code 88361 for digital pathology and how new technologies might be adopted under that or other reimbursement schemes.
Thank you in advance.
+25 Other ResponsesMedical Device Reimbursement
I want to understand how the physician and hospital payment for intracranial hemorrhage treatment for a device used in the angiography suite be different from another device used in the or setting. The scope would include identifying cpt, icd-10 and drg codes for the device used in the angio-suit; codes for the or device are already identified.
+23 Other ResponsesHealtchare Economics & Reimbursement
My name is chris whittington, i represent market access global and am a specialist in healthcare economics and reimbursement in the medical devices arena. We currently have a vacancy for a turkish speaking healthcare economics director based in ankara.
The role of the director, healthcare economics and reimbursement is to provide leadership to support development and implementation of strategic plans at the territorial level that optimize the economic value of the portfolio. This position will provide leadership at territorial level in strategic planning, defining, developing and leading the implementing coverage coding and payment strategies that enhance the position of our products. Exceptional ability to plan for the use of data and evidence to support a value proposition is required.
Responsibilities will include development, implementation, analysis, interpretation, and communication of global health economic and reimbursement (he&r) strategies and projects to demonstrate covidien products’ values across their lifecycle. Collaboration with corporate reimbursement and health economic strategies and objectives, alignment with internal functions of clinical, medical affairs, strategic marketing and pricing, payer relations, global and regional counterparts, and new product development is essential.
Performance of this position is measured in part, by the degree to which “he&r issues” are resolved within emea emerging markets regional markets for covidien products.
Advanced degree preferred or equivalent experience in health policy, health economics, healthcare marketing, research or reimbursement.
• experience in interfacing with external scientific, governmental and regulatory bodies & preference for interactions with reimbursement agencies in emea;
• exposure in value based pricing, product development process, health economics (modeling), and reimbursement;
• prior experience in reimbursement planning or policy (or public health), coding and payment;
• solid understanding of the business of healthcare and the incentives and disincentives which influence product adoption and utilization among clinicians and purchasers;
• international he&r experience with a publication track record in peer reviewed literature and professional presentation history is preferred;
• successful track record of working with a disseminated sales team;
• experience in the medical device industry is strongly preferred;
• experience within one or more emea emerging markets countries is preferred.
I would be most grateful if you could recommend any candidates to me for this role, as it is an urgent vacancy. Please contact me if you can assist me in any way with this.
Yours sincerely
chris whittington
executive search consultant
healthcare economics and reimbursement
market access global
+4 Other ResponsesBilling And Reimbursement In Connecticut
Job title: director, billing & reimbursement
location: new haven, ct
this job post has been authorized by zintro.
**candidate must be located in new haven, ct area and/or driving distance to this location**
**position summary**:
- 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.
**education/experience**:
- bs degree in business or a related field and 8 years revenue cycle experience and 5 years in a leadership role overseeing medical authorizations, managed care and reimbursement employees.
This position is not eligible for visa sponsorship.
+4 Other ResponsesReimbursements For Wound Care In Nursing Homes
We are interested in talking with a medical reimbursement expert about "wound care services in nursing homes" (10 "cpt"). Specifically, we are interested in talking with experts about their view on future potential reimbursement trends for these codes. Our assertion is that these procedures are smaller ticket items (~$100-150 a procedure) and thus not on medicare’s radar for cuts, but we would like to try and support this by talking with people who know how medicare thinks and what they may be targeting for potential cuts in the future. We would like to speak with people who have either previously worked in medicare or are at other agencies or organizations who are very close to the pulse of what medicare is thinking.
Thanks!
+16 Other ResponsesBehavioral Health Insurance Advocacy
Hello - we are a private equity firm working to acquire a business that provides billing and insurance advocacy services to behavioral health companies, including mental health, developmental, and addiction centers.
We are unfamiliar with the sector, and we are interested in speaking with someone who can be a river guide as we perform our due diligence.
Thank you so much.
+34 Other ResponsesMedical Reimbursement
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 ResponsesMedical Reimbursement
**** consulting is a global strategy consulting firm with an emphasis on the life sciences industries. We are currently conducting a study to better understand the payor and reimbursement environment for three cns diseases: major depressive disorder (mdd), alzheimer's disease (ad) and autism spectrum disorders (asd). We are interested in the management of patients and reimbursement decisions pertaining to pharmaceutical therapies.
As part of the study, we want to reach out to health insurance individuals to understand:
- current and future management of the indicated diseases
â- potential utility for a new oral pharmaceutical treatment in development for these indications
+5 Other Responses
