Reimbursement Manager Job Description
Reimbursement manager
provides education and training materials on new processes, regulations or systems related to Clinical Reimbursement of Medicare or Medicaid services.
Reimbursement Manager Duties & Responsibilities
To write an effective reimbursement manager job description, begin by listing detailed duties, responsibilities and expectations. We have included reimbursement manager job description templates that you can modify and use.
Sample responsibilities for this position include:
Analyze data generated by Quadax healthcare billing applications to identify payer reimbursement trends that will assist our clients' managed care teams with payer contracting efforts and assist production operations management
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Identify, lead and develop a team of Reimbursement professionals by fostering teamwork, innovative thinking, and knowledge sharing with team members to enhance service delivery
Develop and maintain strong working relationships with key client executives through hospital “C Suite” contacts
Interact with key accounts within assigned geography to assist the sales force with referral pull-through strategy
Assist with the day-to-day management of the A.S.A.P
Prefer candidate to live in territory geography
Manage Customer Service Supervisors, performance to be measured against job descriptions and Roles and Responsibilities
Manage various projects associated with the growth of the Quadax Reimbursement Support service line
Reimbursement Manager Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Reimbursement Manager
List any licenses or certifications required by the position: PMP, CPC, AHIMA, MT, CT, RAC, CPHQ, HTA, AAPC, RACC
Education for Reimbursement Manager
Typically a job would require a certain level of education.
Employers hiring for the reimbursement manager job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and University Degree in Business, Accounting, Education, Finance, Management, Healthcare, Business/Administration, MBA, Leadership, Communication
Skills for Reimbursement Manager
Desired skills for reimbursement manager include:
Health care reimbursement from a patient and provider perspective
Government
Centers of Medicare & Medicaid Services
Federal payer sectors
Managed Care
Integrated Delivery Network/Integrated Health Systems
Private payer
Medical insurance terminology
Private payer Medicare and Medicaid structure systems and reimbursement process
Diagnostic processes
Desired experience for reimbursement manager includes:
Travel Accident Insurance
Medco Prescription Plan
University degree in natural sciences such as pharmacology, molecular biology medicine, economics or law (Master level)
Fluent in German and English, strong in French
Minimum 2 years’ experience in at least one stakeholder sector within the pharmaceutical reimbursement
Experience with reimbursement dossier compilation
Reimbursement Manager Examples
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Reimbursement Manager Job Description
Job Description Example
Our company is growing rapidly and is hiring for a reimbursement manager. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for reimbursement manager
- Identify and document business functions for future software enhancements
- Assist Quadax account executives with their account management activities, including fulfilling requests for ad hoc reporting using advanced spreadsheet functions such as pivot tables
- Oversee long-range and annual planning for the cross-functional Access & Reimbursement function that includes investment roadmap, vendor management efficiency planning and compliance management for programs and services
- Drives the process for information relative to the access and reimbursement team derived from the external marketplace and internal databases
- Services as a resource to Access and Reimbursement leadership team to analyze business opportunities and coordinates cross-team initiatives in process improvements and efficiencies
- Creates and realizes financial and operational efficiencies in the delivery of services that best meet patient access needs and marketplace challenges
- Prepare annual and final external audit workpapers
- Develop content in keeping with client requests and needs
- Develop and conduct product specific trainings for staff including new hires, refresher trainings, ongoing project and technical trainings
- Responsible for meeting performance metrics established on programs
Qualifications for reimbursement manager
- Financial experience, good commercial understanding - Sound understanding of financial analysis
- Solid understanding of national health care, regulatory environment, of drug P&R and listing processes
- Bachelor's degree in Business Administration or Accounting required
- Extensive knowledge of cost report methodologies and Medicare and Medicaid regulations
- Bachelor’s degree in a business discipline, a major in accounting preferred
- Three (5) years of Medicare and Medicaid cost report preparation experience is required
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Reimbursement Manager Job Description
Job Description Example
Our company is looking to fill the role of reimbursement manager. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for reimbursement manager
- Collaborate with Sales & Marketing to drive sales and grow revenue by identifying new business opportunities CMA services
- Manage programs for profitability
- Participate in training operations staff on client expectations in program design, operations and changes in program scope
- Understands Medicare billing rules
- Collaborate with internal functional groups (Operations, RSG consultants, IT, Finance, PMO, among others) to effectively manage client programs
- Understand, translate and communicate contracted program performance metrics, including Service Level Agreements (SLAs) or Key Performance Indicators (KPIs), client expectations and goals to the operations team
- Participate and lead in training operations staff on client expectations (voice of the client) in program design, day-to-day operations and changes in program scope
- Learn and maintain knowledge of the therapeutic areas impacting the client’s product(s)
- Lead new program launches and initiatives
- Lead in account review/strategic planning exercises with the account director and executive sponsor
Qualifications for reimbursement manager
- Bachelor’s degree, Advanced degree or specific Practice Management experience preferred
- Five (5) years of professional accounting experience in a health care environment
- Knowledge of automated general ledger systems
- Intermediate Excel, Access, Word and Outlook skills preferred
- It is highly preferred that the candidate lives in the metropolitan DC, PA, NY, NJ, MA or CT
- Experience conducting Medicare/Medicaid appeals and disputed issues on behalf of hospitals
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Reimbursement Manager Job Description
Job Description Example
Our company is searching for experienced candidates for the position of reimbursement manager. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for reimbursement manager
- Collaborate with Sales & Marketing to drive sales and grow revenue by identifying new business opportunities based on CMA services
- Provide leadership in CMA initiatives
- Spend considerable time and effort working with customer accounts and field partners in Sales reviewing and maintaining their territory business plans and progress, helping to identify reimbursement-specific opportunities or issues, educating partners on the payer landscape
- Implement programs to support key reimbursement changes
- Identify and monitor payor policy issues and trends that threaten and/or enable market access collaborate with the Healthcare Economics team to evaluate and plan campaigns to influence policy changes
- Serve as a liaison between the sales reps and key external customers
- Hires qualified team members following approved protocols and compensation guidelines
- Sets clear and specific expectations/objectives for team members and the team
- Ensures team members meet subsidiary standards as it relates to the team’s daily responsibilities
- Monitors, documents, and provides ongoing feedback regarding performance
Qualifications for reimbursement manager
- Requires a BS/BA degree preferably in accounting
- University degree in Business, Economics, Pharmacy or Life sciences
- Graduate training in Drug Development, Pharmacy, Epidemiology or Health Economics is an asset
- Graduate degree in Business or Life sciences is an asset
- Five to ten years of relevant experience in the pharmaceutical industry
- Policy & Reimbursement experience (field and strategy) is a major asset
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Reimbursement Manager Job Description
Job Description Example
Our company is looking for a reimbursement manager. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for reimbursement manager
- Exhibits objectivity and openness and takes into consideration other’s views and input
- Prioritizes and organizes workload assignments within the department to meet changing priorities
- Delegates work and follow through to ensure optimal results
- Ensures team members follow all compliance plan standards conforming to applicable guidelines and regulations
- Develops strategies to achieve individual and department goals
- Requires organizational and time management skills necessary to organize special project teams to reach predetermined goals
- Requires the ability to adapt to urgent deadlines or changing priorities and maintain composure in high stress situations at all times
- Exhibits flexibility and integrates changes smoothly
- Actively promotes the practice and Radiologix in all contacts with staff and outside vendors
- Provides monthly work plan updates and advocates change to maximize effectiveness and efficiency
Qualifications for reimbursement manager
- Good understanding of Health Outcomes and ability to develop brand strategies
- Solid facilitator coupled with strong negotiation/analytical and project management skills
- Business acumen with strong scientific knowledge
- Ability to interact with executives or key customers
- English proficiency/French is a major asset
- Must have Specialty experience on the reimbursement, provider or operations side
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Reimbursement Manager Job Description
Job Description Example
Our company is growing rapidly and is hiring for a reimbursement manager. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for reimbursement manager
- Monitors and controls staffing and budget expenses
- Provides input and necessary info during the budget process
- Remains current on applicable billing and reimbursement changes, guidelines, and updates
- Assesses job-specific competencies
- Provides support to assigned hospitals for calculation of monthly contractual adjustments
- Develops and monitors schedule for internal chart reviews and conducts reviews of documentation/coding and billing utilizing advanced, specialized knowledge of medical codes and coding procedures for clinic billing to assign and sequence appropriate diagnostic/procedure billing codes in compliance with governmental payer requirements
- Maintains and updates charge documents with new and deleted codes in cooperation with clinic leadership, PAANS and Finance IT systems
- Maintains knowledge of coding and billing requirements
- Develops a means of measuring the effectiveness of training programs through testing, surveys
- Work with the business team to develop a priority list for evidence programmes for the UK
Qualifications for reimbursement manager
- Must have a valid driver's license with a clean driving record/ MVR
- Must be able to travel 80% (4 days a week) via automobile or plane
- Bachelor’s degree, Advanced degree or specific Practice Management experience required
- Must have experience with specialty providers (neurology, oncology, rheumatology, urology, gastroenterology) on the reimbursement, provider andoperations side
- Research and compile provider / manufacturer representative-specific information for reimbursement database
- Bachelor’s Degree preferably in business or healthcare-related field