Job details
Job type full-time
Full job description
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Our mission at progenity is simple: to help healthcare providers and patients prepare for lifeWe provide the most advanced molecular technology and the highest levels of service to guide patient care at critical life stagesWe continually seek people with the motivation and skills to advance our mission.
The senior director of reimbursement operations works with the vice president of billing and reimbursement to provide direction and leadership to reimbursement operations leadership team and staffThis position involves strategic supervision of all reimbursement operations for the companyIn addition, this position is responsible for overseeing collections for all insurance carriers and is responsible for the timely collection of all claims while meeting the performance standards and goals f or the department.
Responsibilities
· develops, plans, organizes, and implements current and future reimbursement strategies.
· maintains vendor relationships.
· works closely with progenity’s 3rd party billing vendor to ensure accurate reporting and efficient collection of funds.
· partners with the internal health plans team to ensure all payor policies are being followed and appeals are processed within the terms of the agreement.
· oversee existing full cycle ap operations and manage daily activities for successful execution of strategies that offer automation, strengthen interna l controls, and build process efficiencies where needed to satisfy industry best practices and recommendations.
· improves cash flow and improves the overall efficiencies of the company’s receivables.
· standardization of reporting for finance and senior management for key metrics.
· oversight of all billing related functions.
· stakeholder for chargemaster to ensure maximum reimbursement and pricing.
· sop generation and standardization of employee tasks.
· puts controls in place for key operational functions.
· oversees the daily operations of the reimbursement department including workload and staffing; hiring, disciplining and performance appraisals; training’ and monitoring quality of work.
· develops long-range and short-term goals, objectives and plans and ensures they are implemented effectively.
· work collaboratively with all levels of personnel and management on revenue cycle performance to meet strategic goals and develop all guidelines, policies, and procedures through use of data analysis.
· monitor employee productivity and provide constructive feedback and coaching as needed.
· assess departmental capabilities and monitor staff performanceIdentify development needs.
· organizes and oversees the schedules and work of department supervisors as assigned.
· ensures supervisors manage their departments efficiently and in accordance with departmental goals.
· organizes and oversees the schedules and work of department supervisors as assigned.
· ensures supervisors manage their departments efficiently and in accordance with departmental goals.
· daily, monthly and annual reporting, benchmarking and trending maximizing technology to improve functionAnalyzing and summarizing data with subsequent communication to senior leadership and clinical operations.
· strategically identifies and communicates critical success factors necessary to support financial and organizational goals.
· supervise the use of revenue information systems/ software and maintain a comprehensive working knowledge of the system, reporting relevant information to senior leadership.
· recruit, motivate and develop professional operations team to inspire commitment and engagement and improvement performance standards.
· assists in planning, developing, and controlling the budget, including staffing costs, capital equipment, and operations of the department.
This list of duties and responsibilities is not all inclusive and may be expanded to include other duties and responsibilities, as deemed necessary.
Requirements
Bachelor’s degree in finance or related field requiredAdvanced degree preferred.
Minimum 10 years of experience in medical billing.
Minimum 7 years of management experience.
Working knowledge and hands-on experience with medical billing and reimbursement strategies.
Experience with the quadax billing system a plus.
Working knowledge of appropriate coding systems; cpt, icd-9/ icd-10 and hcpcs, coverage; lcd/ncd and reimbursement associated with associated codes.
Excellent verbal and written communication skills.
Problem solving skills, good judgment, attention to detail, and follow-through are musts.
Ability to analyze and interpret data and solve practical problems.
Must be able to handle a wide work variety in a fast-paced environment.
