Reimbursement Manager

Bioscrip, Inc. Aurora , CO 80041

Posted 5 days ago

BioScrip, Inc. is the largest independent national provider of infusion and home care management solutions, with approximately 2,100 teammates and nearly 70 service locations across the U.S. BioScrip partners with physicians, hospital systems, payors, pharmaceutical manufacturers and skilled nursing facilities to provide patients access to post-acute care services. BioScrip operates with a commitment to bring customer-focused pharmacy and related healthcare infusion therapy services into the home or alternate-site setting. By collaborating with the full spectrum of healthcare professionals and the patient, BioScrip provides cost-effective care that is driven by clinical excellence, customer service, and values that promote positive outcomes and an enhanced quality of life for those it serves. Ours is a fast-paced dynamic work environment with room for new ideas and opportunities for career advancement. We offer a wide array of welfare benefits as well as Tuition Reimbursement, an Employee Referral Program, and a 401(k) Retirement Savings.

Reimbursement Manager

SUMMARY

This position plans and manages the Reimbursement Department in compliance within all legal and regulatory parameters and Company policy and procedure. Holds the department accountable in meeting deadlines and established Company goals. Works in cooperation with all other branch departments and the Reimbursement Director.

ESSENTIAL FUNCTIONS

To perform this job successfully, an individual must be able to perform each essential function satisfactorily, with or without reasonable accommodation.

  • Promotes an environment which encourages accomplishment of company and staff objectives.

  • Monitors billing/collections staff efficiency through audit processes.

  • Coordinates with center-level management with development and training of new and existing Reimbursement personnel.

  • Maintains updated knowledge of industry, regulatory and reimbursement issues.

  • Initiates and maintains electronic billing.

  • Ensures Company pricing and discount policies are administered correctly.

  • Reviews new contracts, incorporates into system and educates staff.

  • Monitors large accounts and intervenes as appropriate to ensure timely reimbursement

  • Researches and resolves problem accounts to ensure collection standards and decrease days sales outstanding (DSO).

  • Approves adjustments as per Company policy.

  • Assists with month-end closing as scheduled to assure timeliness.

  • Attends required in-services each year.

  • Ensures employee attendance to all required training sessions and inservices.

  • Works collaboratively with other departments, including operations and managed care, to improve reimbursement process and results.

  • Directs, coordinates, and evaluates reimbursement staff and carries out supervisory responsibilities in accordance with the Company's policies and applicable laws. Responsibilities may include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; succession planning; rewarding and disciplining employees; addressing complaints and resolving problems.

  • Complies with Human Resources policies for department. May delegate policy components, but retains responsibility for performance.

  • Each employee is responsible for adhering to those performance programs, policies, procedures, guidelines and internal control standards established to guide the operation of the Company. Each employee must be made aware of and understand proper internal control procedures associated with their specific job function as communicated by his/her manager.

  • Each employee is responsible for reporting concerns that he or she may have with respect to deficiencies in internal control.

  • Managers and supervisors are responsible for ensuring that internal controls are established and functioning to achieve the mission and objectives of their unit. Each employee within an area under the manager or supervisor's direction must be made aware of and understand proper internal control procedures associated with their specific job function.

  • Managers and supervisors must acknowledge that utilization of internal controls is an inherent part of a manager's responsibility, not a new or additional function, and assure that internal controls are supportive of and consistent with the operating mandate and philosophy of the Company.

  • Performs other duties as assigned.

SUPERVISORY RESPONSIBILITIES

  • Management responsibility for all Reimbursement staff; may direct subordinate supervisors.

EDUCATION, TRAINING AND EXPERIENCE REQUIREMENTS

High school diploma or equivalent is required, bachelor's degree is preferred; Minimum of five (5) years of collection and billing process experience with all major commercial and governmental third party payers; Minimum of three (3) years proven supervisory or management experience; Infusion, home health or DME experience is preferred; Experiential requirements may be waived in lieu of evidence of progressive growth in and attainment of the skills necessary to perform the required duties.

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED

The requirements listed below are representative of the knowledge, skill, and/or ability required, with or without reasonable accommodation.

  • Working knowledge of medical terminology.

  • Knowledge of HCPCS coding.

  • Knowledge of ICD 9 coding.

  • Knowledge of NDC coding.

  • Knowledge of electronic billing.

  • Knowledge of Zirmed.

  • Knowledge of CPR+.

  • Excellent calculation/math skills.

  • Ability to understand insurance contracts for billing purposes.

  • Ability to prioritize and handle multiple tasks and projects concurrently.

  • Strong interpersonal and communication skills and the ability to work effectively with branch departments.

  • Demonstrated knowledge and proficiency in the principles, procedures and best practices related to this position.

  • Proficient level of software proficiency in using PC software to support activities, especially Microsoft Office.

  • The ability to work with confidential material and maintain confidentiality is required along with sensitivity to employees and customers needs and data.

  • Strong attention to detail.

  • Proficient analytical skills.

  • Proficient in MS Office.

Language Skills

Ability to read, analyze and interpret information appropriate to duties and responsibilities assigned. Ability to operate information systems, follow policy, complete required forms, and prepare reports. Ability to effectively present information and respond to questions from patients, and payors.

Mathematical Skills

Ability to perform basic mathematical calculations.

Reasoning Ability

Ability to define problems, collect data, establish facts, and draw valid conclusions.

BioScrip is an equal opportunity employer. All employment decisions are made without regard to age, color, race, ancestry, national origin, disability, genetic information, military status, religion, creed, sex, pregnancy, childbirth, marital status, citizenship, sexual orientation, gender identity, gender expression, legally protected medical condition, or any other basis prohibited by applicable law. Background checks and drug screens are part of our hiring process. Affirmative Action/Equal Opportunity Employer, Minority/Female/Disabled/Veteran.


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