Reimbursement Manager

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Job Title: Reimbursement Manager

Company Name:	Allegheny County Careers
Location:	Pittsburgh, PA
Position Type:	Full Time
Post Date:	09/10/2024
Expire Date:	02/19/2026
Job Categories:	Accounting/Auditing, Administrative and Support Services, Finance/Economics, Government and Policy, Healthcare, Practitioner and Technician, Information Technology, Insurance, Other / General, Real Estate, Executive Management, Medical

Job Description

Reimbursement Manager
<div class="input-group"> Position Title: Reimbursement Manager <div id="MainContent_noresults"> Salary: $55,000.00 - $57,999.96 per year How to Apply: Applications are submitted online until the position is filled and/or the posting is closed. After reviewing this job announcement, please click on the link at the bottom of the page to apply online. A resume is required with the application. Further instructions on submission of documents are available in the online application. A resume may not be substituted for an application. <div id="box" style="border: solid; padding: 15px; border-color: gold; background-color: lightgray;"> Minimum Requirements: <ul><li>An Associates degree in Business Administration, Accounting, Financial Management, or a related field AND three (3) years of experience in medical reimbursement in a hospital, long term care, or other health related facility to include one (1) year of supervisory experience. </li><li>An equivalent combination of education, experience, and training is acceptable. </li></ul> It is the policy of Allegheny County that in order to receive a final offer of employment, candidates must successfully pass a background check, which includes verification of Allegheny County Real Estate Tax status. </div> Position Summary: Incumbent supervises and participates in the processing of reimbursements from Part B Medicare and coinsurances for ancillary charges to DERMC. Work is performed in accordance with Federal, state and local standards, guidelines, and regulations that govern long-term care facilities under the direction of the Revenue Controller. Overview: Duties: <ul><li>Supervises the work of subordinate staff, through assignment of work, establishment of priorities, approval of leave requests, and the completion of performance appraisals.</li><li>Applies payments daily from Medicare and coinsurances using Solution One & SOS programs.</li><li>Determines residents’ insurance coverage status and qualifications for either Medicare Part B billing or non Medicare B billing and inputs into appropriate programs.</li><li>Tracks unpaid and rejected claims.</li><li>Organizes billing documentation for enteral and wound care claims.</li><li>Inputs billing information and documentation.</li><li>Prepares requests for missing or additional documentation for wound care from nursing representatives.</li><li>Receives weekly wound care reports, supply orders, and doctor’s orders.</li><li>Prepares and submits claims for wound care to Medicare Part B and obtains acknowledgement reports of accepted claims.</li><li>Receives enteral monthly report from Resident Service Managers and Dietitians and makes any corrections or requests any needed documentation.</li><li>Prints insurance, census, and ICD9 code reports for Resident Services Managers and Dietitians.</li><li>Inputs Part B enteral and projected enteral changes for following months and actual enteral changes on non-B residents.</li><li>Compiles and sends to Medicare reviews for under and unpaid claims.</li><li>Provides in-service information to nursing and dietary staff on the documentation required to support reimbursement for charges related to ancillary services.</li><li>Performs related tasks and other duties as assigned by the Revenue Controller.</li></ul> Knowledge, Skills, and Abilities Knowledge of: <ul><li>Principles and practices of supervision.</li><li>Medicare and Medicaid regulations regarding reimbursements. </li></ul> Skill in: <ul><li> Microsoft Office Suite</li></ul> Ability to: <ul><li>Operate a personal computer.</li><li>Relate to and work with ill, disabled, elderly, and emotionally upset people within a long-term care facility.</li><li>Communicate effectively with vendors, employees, applicants, residents, family members, visitors, government agencies, and general public. </li><li>Read, write, and understand written and oral instructions.</li></ul> Residency: Allegheny County within 1 year. Veterans' Preference: Will be awarded to eligible candidates. <div id="Needtocenterandbold" class=" text-md-center font-weight-bold"> AN EQUAL OPPORTUNITY EMPLOYER - M/F/V/D </div> <div id="Needtocenterandbold2" class=" text-md-center font-weight-bold"> <a href="https://apps.alleghenycounty.us/HRJobApplication/firstpage.aspx?id=2807" id="MainContent_Applyonline">Apply Online</a> </div> </div> </div>

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Contact Information

Company Name:

Allegheny County Careers

Website:

https://apps.alleghenycounty.us/hrjobportal/details.aspx?id=2807

Company Description:

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