Director of Reimbursement

Job Locations: Corporate Office
Job Type:

Baptist Village of Oklahoma City has an immediate opening for a Director of Reimbursement.

POSITION SUMMARY/CHARACTERISTICS:

Management of billing systems and processes and supervision of billing staff. The Director of Reimbursement is responsible for directing the Billing Team support staff. Must possess ability to set priorities, recognize and resolve problem situations, make decisions independently and evaluate effectiveness. Remain flexible, able to handle multiple requests, as well as facilitate and support change. Motivated to remain current on Medicare, Medicaid, and insurance billing rules of federal and state requirements and other regulatory agencies/entities. Must demonstrate the ability to handle stressful situations and serve as a role model for team members.

PHYSICAL WORKING REQUIREMENTS:

  • Inside office environment
  • Sitting approximately 80% of workday

POSITION DUTIES:

  • Manage Medicare/Medicare Advantage, Medicaid/Medicaid Advantage and other third party payer monthly claims ensuring each are billed and processed timely.
  • Ensure all payments are posted in billing software timely.
  • Address and resolve billing issues as they arise. Provide support to locations for management of accounts receivable balances.
  • Serve as administrator for various claim processing systems and websites.
  • Perform month-end close and produce month end reports for management.
  • As needed, create reports for room & board rate increases as well as home health rate increases and update and maintain rate codes in billing software.
  • Supervise billing staff.
  • Other duties as assigned by the Controller or Chief Financial Officer.

KNOWLEDGE, SKILLS, AND ABILITIES:

  • Ability to maintain integrity and trust among leadership and staff
  • Proven ability to manage a team of professionals and lead a departmental function
  • Demonstrated business acumen. Demonstrated business understanding and ability to balance people/organizational decisions with business considerations.
  • Must be strategic thinker, self-motivated and have excellent problem solving and project management skills.
  • Proven ability to effectively manage multiple high priority deliverables
  • Excellent verbal and written communication and presentation skills
  • Proficient with the use of Microsoft Office tools, My Unity, Quies (OASIS), EPS (Claim Clearing House), Smarter email (Medicaid, OKDHS), OHCA (Medicaid), eSolutions and all associated portals.

MINIMUM QUALIFICATIONS:

  • Bachelor’s Degree in related field or equivalent experience.
  • Minimum of 2-5 years experience in successful billing of home health and/or nursing home services, Medicare, Medicaid, third party payers.
  • Knowledge and understanding of Explanation of Benefits.
  • Experience in follow-up with insurance providers regarding submitted claims.
  • Experience with collections on past due accounts.
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