Manager, Reimbursement

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

Advent Health Respiratory and Equipment (AHRE) is a leader in providing ventilators, oxygen, sleep apnea treatment, wound care solutions, diabetic solutions and home medical equipment. We help patients lead a more comfortable and productive life by keeping them engaged in their care and empowering them to manage their health and treatment at home. A unique joint venture partnership between Advent Health and CarepathRx, AHRE has the unique opportunity to grow significantly as we expand to serve Advent Health’s expanding footprint of facilities and services throughout Florida.

Reporting to the Director of AHRE, the Reimbursement Manager (RM) will serve as the leader and manager of a group of Billers and Account Receivable Teams. This includes providing guidance to financial audiences and partnerships that represent a deep understanding of industry knowledge and AHRE operations. The RM will collaborate internally with AHRE leadership and Outsourced financial Vendors.  The RM is a directly impacts the success of critical strategic financial.

Responsibilities

• Assumes responsibility for directing all day-to-day activities related to revenue cycle

• Provides leadership and direction to supervisory and manager level staff to meet or exceed business objectives

• Analyze and trend claims related data to identify inefficiencies and implement process improvement.

• Lead work groups with the ability to identify problems and propose systematic solutions and develop/maintain necessary work plans

• Lead and supervise Reimbursement supervisors along with other team members, providing guidance, coaching, and support to ensure high performance and productivity.

• Set clear expectations and goals for team and monitor performance metrics and key performance indicators (KPIs) to track progress and identify areas for improvement.

• Demonstrate healthcare industry knowledge pertaining to health plans, and qualifications needed to facilitate referrals request

• Possess a willingness to obtain a deep understand of AdventHealth Respiratory and Equipment operations

• Maintains compliance accountability specific to claims administrations in accordance with applicable state and federal laws

• Provide leadership and direction through developing and updating policy and procedures, programs, determining appropriate standards and procedures, determining staffing requirements, and training opportunities

• Performs other duties as assigned.

Skills & Abilities

• Knowledge of EMR Billing software

• Ability to relate well to others and easily build rapport

• Detail oriented with ability to manage multiple relationships and partners

• Expert knowledge of medical equipment revenue cycle workflows

• Ability to influence and drive change positively both internally and externally

• Superior follow through and possess a sense of urgency in partner and patient issues

• Analytical with good presentation skills; ability to learn how to analyze data and represent data in group settings

• Ability to work through ambiguity

• Self-directed

• Ability to remotely communicate, cascade information and follow up with direct reports on a routine basis

• Effectively communicate both oral and written

• Maintain confidentiality when facilitating sensitive information

Requirements

• Four-year bachelor’s degree or equivalent in Respiratory/Durable medical equipment experience.

• Two (2+) years in a management position, is preferred.

• Demonstrates knowledge of Federal/State rules and regulations, ACHA standards, and other regulatory requirements.

• Must be familiar with general use and functions of the computer, such as, usernames, password concepts, internet, email, navigation of computer desktop, including starting programs, using files, and windows, effective use of navigation buttons and tool bars, ability to self-manage online HR services and online training programs. 

• Ability to assume a flexible work schedule.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.