Tuesday, March 7, 2017

Physician Services Manager - Claims - Cincinnati Area

Position Title          Physician Services Manager - Claims - Cincinnati Area 


Relocation               Yes


Location                  Cincinnati Area


Position Summary: Primarily responsible for leadership and management of the Physician Services Department.


General Purpose:  Leadership; problem resolution; critical thinking; auditing; relationship and team building; process development and improvement


Essential Duties and Responsibilities:

Interview, hire, train, audit and review team membersCoach, mentor and develop staff, including overseeing new employee onboarding and providing development and ongoing education opportunities for the Physician Services Department.Lead employees to meet the organization's expectations for productivity and goal achievement.Oversee the quality of all projects and ensure compliance with coding and billing guidelinesPlan and allocate resources to appropriately staff each assignmentEvaluate and improve departmental operating procedures to enhance speed, quality, efficiency, and overall effectivenessTrack various departmental information in order to develop and maintain benchmarks, create goals, manage trends, identify areas of opportunity and weakness, identify issues and training opportunitiesParticipate in workflow examination or special projects as neededPrepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment postingExamine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports, electronic tools and supporting documentation.Perform duties and responsibilities of Claims Analyst as neededMaintain regular contact with necessary parties regarding project status including clients, managers, and other personnelBuild strong, lasting relationships with clients, payors and company personnelOrganize, prepare and/or attend department, client and company meetingsComply with federal and state laws, company policies and procedures


Essential Skills and Experience:

Minimum 5-years Management experienceMinimum 3-years Coding experience, with certificationExcellent interpersonal skills with proven ability to motivate and lead a teamAbility to communicate at a professional level, orally and in writing (in English)Strong customer service orientationExperience preparing and presenting information at an Executive levelModerate to advanced Microsoft ExcelModerate Microsoft WordModerate computer proficiencyMathematical skills:  ability to calculate rates using addition, subtraction, multiplication and divisionAbility to read and interpret an extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram formAbility to define problems, collect data, establish facts and draw valid conclusionsStrong team playerCommitment to company valuesHigh school diploma or equivalentAbility to travel by automobile or public transportation to visit or setup work sites


Nonessential Skills and Experience:

Auditing experience is a plusRelated Professional License/CertificationsAssociate or Bachelor's Degree

Reporting To This Position:  Physician Services Analysts



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