Senior Physician Reimbursement

Job Description

The best thing about this role

Are you looking to make a difference by improving the health of our patients? Here you will find an innovative culture that is patient-focused and dedicated to making a difference. We are committed to helping the population we serve, and our communities, achieve optimum health and enjoy the best quality of life possible.

What You'll Do

Under the general supervision of the Manager, Provider Enrollment Delegated Credentialing provides ongoing monitoring and interpretation of regulatory requirements and their impact on physician practice operations. This position will insure strict compliance with governmental rules and appropriate reimbursement utilizing research. This role will maintain compliance with Facility Enrollment and Payor RE-Credentialing for Bassett Healthcare Network.

• Research and monitor governmental requirements related to charging and billing practices.
• Monitor, summarize and disseminate updated regulatory requirements to appropriate staff.
• Support Manager, Provider Enrollment Delegated Credentialing on enrollment related tasks to ensure compliance.
• Medicare Revalidations to support Provider and Facility enrollment.
• Monitor compliance topics as outlined in the Corporate Compliance Council work plan.
• Develop and maintain catalogue of reference resources and updates from CMS and NYS regarding regulatory requirements.
• Assure regulatory compliance utilizing chart to claim pre-billing reviews.
• Maintain Physician Billing procedure manual and regularly test compliance utilizing chart to claim pre-bill reviews.
• In cooperation with Physician Billing, manage payer review requests and rejections (e.g. Recovery Audit Contractor, CERT Contractor, etc.). Provide feedback to Physician Reimbursement manager regarding trends and educational opportunities.
• Track reviews and provide periodic reports of Physician Billing and Reimbursement activities to management and Corporate Compliance Council.
• Support EPIC. Document updates and back up for changes.
• Complete and track Payer RE-Credentialing for Bassett Healthcare Network and physician group as needed.
• Based on chart to claim review results, make recommendations to the Physician Reimbursement Manager for corrective action plans and educational requirements.
• Maintain Coding/Physician Billing/Reimbursement intranet page.
• Provide coding and reimbursement knowledge base.
• Research and summarize regulatory issues as requested.
• Provide coding and billing support for “hot topics”. Act as liaison between Physician Billing, clinical departments and coding staff.
• Is receptive to reimbursement/coding inquiries as observed by manager and/or staff feedback.
• Based on manager observation, uses interpersonal skills effectively to build and maintain cooperative working relationships at all levels of the organization.
• Expands job-related knowledge and skills to improve performance.
• Fulfills annual requirements for maintaining professional certification as noted by manager.
• Regularly attends unit meetings as observed by manager.
• Demonstrates the ability to adapt to changes in workload and work environment as observed by manager.
• Performs similar or related duties as requested or directed.
  
  

Education

What we need from you

• 4 Year/Bachelor's Degree, preferred
• concentration in healthcare reimbursement and/or healthcare administration, preferred
• experience may be considered in lieu of education
• **Or
• 2 Year/Associate Degree, required
• concentration in healthcare reimbursement and/or healthcare administration, preferred
• experience may be considered in lieu of education
• **Or
• High School or GED highly preferred with an additional 2 years experience in physician group practice revenue cycle and/or 3rd party payer operations
  

Experience

• Minimum 4 years experience in physician group practice revenue cycle functions and/or 3rd party pater operations, required
  
  

Licensure/Certifications

• Current coding certification granted by the AAPC or AHIMA required or ability to obtain within 1 year from date of hire, required
  
  

Skills

• Organizing/Categorizing records
• Interacting with People
• Communication
• Accounting
• Computer Skills
  
  

Physical Requirements

• Sedentary Work - Exerting up to 10 lbs of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking or standing are required only occasionally, and all other sedentary criteria are met
• Occasional lifting, pulling, pushing, reaching, standing, walking
• Frequent typing/clerical/dexterity, hearing, repetitive motion, seeing/monitor/computer use, talking, visual acuity (color, depth, perception)
  
  

Travel

• No travel required
  
  

Total Rewards

Benefits

Bassett Healthcare Network’s commitment to our employees includes benefit programs carefully designed with the needs and values of all our employees in mind. Many of the benefits we offer are paid fully or in large part by Bassett. Our generous benefits offerings include:

• Paid time off, including company holidays, vacation, and sick time
• Medical, dental and vision insurance
• Life insurance and disability protection
• Retirement benefits including an employer match
• And more!
  
  

Specific benefit offerings may vary by location and/or position.

Pay Range

Salary is based on a variety of factors, including, but not limited to, qualifications, experience, education, licenses, specialty, training, and fair market evaluation based on industry standards. The above compensation range represents a good faith belief of the compensation range by Bassett Healthcare Network, and its entities and affiliates, at the time of this posting or advertisement.

Pay Range Minimum

USD $30.15/Hr.

Pay Range Maximum

USD $45.23/Hr.

We love the difference people bring

We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex (including pregnancy, childbirth, or related condition), age, national origin or ancestry, citizenship, disability, marital status, sexual orientation, gender identity or expression (including transgender status), genetic predisposition or carrier status, military or veteran status, familial status, status as a victim of domestic violence, or any other status protected by law.