Reimbursement Manager
Reimbursement Manager
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1 Vacancy
Job Description
Purpose: The Reimbursement Manager is responsible for overseeing the reimbursement processes for Lingraphicas products and services. This role ensures efficient and compliant operations within the Revenue Cycle Management (RCM) team optimizing reimbursement workflows claim submissions denials management and payer relationships. The ideal candidate has a strong background in healthcare reimbursement insurance authorizations billing and compliance with a focus on process improvement and operational efficiency.
Essential Duties and Responsibilities:
Claims & Reimbursement Operations
- Oversee the endtoend reimbursement process including claim submission followups appeals and denials management.
- Ensure timely and accurate billing to private insurers Medicare Medicaid and other payers.
- Develop and implement strategies to optimize reimbursement rates and reduce claim denials.
- Monitor reimbursement trends payer policies and regulatory updates to ensure compliance.
Process Optimization & Compliance
- Identify opportunities for workflow improvements within the reimbursement function.
- Collaborate with internal teams (Funding Contracts Customer Support) to streamline reimbursement processes.
- Ensure adherence to all payer guidelines HIPAA and compliance requirements.
- Provide training and guidance to team members on reimbursement best practices and policies.
Stakeholder Management
- Serve as a key point of contact for reimbursementrelated escalations and disputes.
- Work closely with internal stakeholders to improve communication between Revenue Cycle Sales and Customer Support teams.
- Performs quarterly and annual reviews for the Reimbursement team
- Conducts weekly Reimbursement team meetings
- Performs weekly 11 meetings with direct reports
- Provides ongoing performance feedback addresses problems determines staffing needs interviews and hires staff orients and trains employees verifies competency and identifies and suggests ways to develop skills
Data & Reporting
- Track and analyze reimbursement performance metrics including claim acceptance rates denial rates and reimbursement timelines.
- Generate reports to provide insights into reimbursement trends opportunities and financial impacts.
- Develop action plans based on datadriven insights to improve overall reimbursement efficiency.
Qualifications :
Qualifications & Experience
- 5 years of experience in healthcare reimbursement medical billing or revenue cycle management.
- Leadership experience with the ability to manage and mentor team members effectively.
- Strong knowledge of Medicare Medicaid private insurance and payer reimbursement policies.
- Experience with claims processing denials management and appeals.
- Familiarity with healthcare compliance regulations (HIPAA CMS guidelines etc..
- Proficiency in billing and reimbursement software electronic health records (EHR) and reporting tools.
- Strong analytical problemsolving and communication skills.
Additional Information :
Work Environment & Physical Demands
Employee works from home and is expected to maintain a safe productive work environment with secure internet access. Must be able to operate a computer with or without reasonable accommodation.
Travel
Travel is required toPrinceton NJ or another location within the US for meetings approximately 2x / year. Other occasional travel may be needed if business needs arise.
Accommodations
To perform this job successfully an individual must be able to perform each essential duty and physical demand satisfactorily. The requirements listed above are representative of the knowledge skills and/or abilities and physical demands required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
To learn more about Lingraphica visit: !
This Organization Participates in EVerify and will provide the federal government with your Form I9 information to confirm that you are authorized to work in the U.S.
Este empleador participa en EVerify y proporcionar al gobierno federal la informacin de su Formulario I9 para confirmar que usted est autorizado para trabajar en los EE. UU.
Remote Work :
Yes
Employment Type :
Fulltime
Employment Type
Remote
