Directs claim reimbursement activities to facilitate accurate, timely, and compliant operations. Establishes and monitors procedures for filing reimbursement claims. Provides technical oversight to ensure claim activities adhere to regulatory standards, requirements, and guidelines. Develops processes and controls to verify policy details, validate charges and coding, and ensure claim accuracy and completeness to facilitate timely reimbursement. Analyzes reimbursement trends, financial data, and key performance indicators to identify areas for improvement and drive data-informed decision-makin ...g. Remains knowledgeable of payer policies, regulatory reporting requirements, and financial objectives. Requires a bachelor's degree. Typically reports to senior management. Manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function.More Show Less
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