Skip navigation
Unable to save this job. Please try again later.

{msg}

Email this Job to Yourself or a Friend

To begin the application process, please enter your email address.

Company Contact Info

  • Linthicum Heights, MD

Already have an account?

Sign in to apply with your saved resumes.

New to CareerBuilder?

Don't have an account? Continue as a guest!

Sorry, we cannot save or unsave this job right now.

Report this Job

Trust and Site Security Team.

Don't miss out on new jobs!

Get the latest Reimbursement Manager jobs in Linthicum Heights, MD delivered directly to your inbox. You can unsubscribe at any time.

Saving Your Job Alert

Job Alert Saved!

Could not save Job Alert!

You have too many Job Alerts!

This email address has reached the maximum of 5 email alerts. To create a new alert, you will need to log into your email and unsubscribe from at least one.

Sign Up

or   Sign In Here
Password Must Contain
• 
8 to 15 characters
• 
1 uppercase letter
• 
1 number or symbol
• 
1 lowercase letter
Cancel
Create an Account with CareerBuilder to save jobs & unlock these great features
See similar job titles and skills to help you make your next move
Upload a resume and become visible to Hiring Managers and Employers
Compare Salary Information to see where you stand amongst your peers
Easily Quick Apply to jobs with just one click!

Email Send Failed!

Manager of Reimbursement

University of Maryland Medical System • Linthicum Heights, MD

Posted 1 month ago

Job Snapshot

Full-Time
Healthcare - Health Services
Finance, Human Resources, Information Technology

Job Description

What You Will Do:

I. General Summary

Under general supervision manages the operations of the Reimbursement and Revenue Advisory Services Department of the University of Maryland Medical System. Manages, trains, recruits, coaches and develops reimbursement staff within his/her specialized function. Implements, reviews, and modifies all work related to reimbursement methodologies in compliance with HSCRC, federal, state, and local laws/regulations.

II. Principal Responsibilities and Task

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classsification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Manages, trains and directs staff in accordance with departmental and UMMS personnel policies and procedures.
2. Supports strategic goals by gathering pertinent business, financial, service and operations information; identifies and evaluates trends and options; chooses a course of action; defines objectives; evaluates outcomes.
3. Communicates regularly with decision support, financial reporting, hospital departments, health information management (HIM), clinicians, UM School of Medicine, and others to ensure compliance of all regulations and optimal effectiveness of financial reporting.
4. Keeps abreast of current regulatory information/guidelines and coaches others to do the same; communicates relevant changes and/or protocol and procedural revisions to senior management and staff. Implements appropriate departmental operational changes to ensure compliance. Participates in HSCRC and industry meetings and workgroups.
5. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.
6. Coordinates external HSCRC and other regulatory audits to ensure that all information is available and completed on a timely basis.
7. Possesses an experienced and full knowledge and understanding of the skills necessary for the specific functional area in which they are assigned:
Specialization

The following statements are intended to describe the specialized skillset required to work in the defined functional area. People assigned to this classification are expected to have an intermediate to advanced knowledge/understanding of the skills listed.

Case Mix Oversight
1. Knowledge of case mix abstract data including how it is accumulated and processed, CMI analysis, and HSCRC quality programs such as MHAC, RRIP, & PAU.
2. Ability to aggregate/manipulate large datasets containing financial, demographic, utilization, and clinical data elements from disparate data sources using various Microsoft Access/Excel, SAS and Tableau data manipulation tools.
3. Ability to effectively communicate and present HSCRC case mix, quality and utilization technical information to a diverse groups including finance, clinicians, administration staff, and others within the industry.
Charge Description Master (CDM) Oversight
1. Knowledge of charge master components, coding and Epic charge master description application.
2. Ability to oversee the processes to establish, maintain and continuously update and monitor the accuracy of the charge master files in various hospital and clinical systems, including oversight of annual CPT and quarterly HCPCS updates, compliance to State and Federal billing / compliance regulations.
3. Knowledge and understanding of all charge processes within the organization and providing oversight to staff who assist other department managers/directors with determining chargeable services and appropriate CPT/HCPCS coding. Ensure clinical department staff comply with established charge capture and charge reconciliation policies and procedures.
Policy and Methodology
1. Initiates and develops new reporting and/or analysis of UMMS hospital performance on various HSCRC policies and methodologies to enhance revenue maximization and/or performance improvement opportunities.
2. Identifies opportunities and provides analytic and data support for system-wide Clinical Performance Improvement (CPI) strategic initiative.
3. Assists with the negotiation, financial analysis & reporting for risk contracts associated with UMMS Physician Quality Care Network (QCN).
Rate Setting
1. Knowledge and experience in HSCRC reimbursement, Maryland Healthcare Commission (MHCC), and HSCRC/Medicare Cost Reporting.
2. Ability to understand, interpret, measure and formulate financial models along with the development of UMMS’ strategies related to local and national reimbursement policy changes.
3. Ability to effectively communicate and present HSCRC rate methodology, quality and utilization, as well as technical information to a diverse groups including finance, administration staff, executives and other external stakeholders.
Research Billing Compliance
1. In collaboration with Sr. Manager and Director, develops management and operational systems that support the implementation of policies, procedures and standards that govern research activities in all UMMS business units.
2. Oversees the accurate addition of any and all appropriate modifiers, condition codes, diagnosis codes, etc. to identify patient charges on claims submitted to 3rd party payers, including Medicare, as part of an IRB approved clinical trial/research study.


IV. Education and Experience

1. Bachelor’s degree is required. Specialization in Healthcare, Finance, Accounting or equivalent related subject is preferred.
2. Four (4) years professional financial, reimbursement, or analysis experience is required.
3. Pervious supervisor or manager experience is preferred.
4. Healthcare-related finance background is preferred.

V. Knowledge, Skills and Abilities

1. Demonstrated knowledge of HSCRC reimbursement methodologies is required. Knowledge of state and federal reimbursement laws and regulations is required. Knowledge of ICD-10 and AMA Current Procedure Terminology (CPT) preferred. Proficiency in preparing and analyzing financial data and implementing changes to contain costs for budgetary purposes.

2. Effective at supervising, monitoring daily work activities, evaluating, training and motivating performance of subordinate technical, professional and clerical support staff.

3. Effective organizational and problem-solving skills are required to develop/implement efficient work processes and to successfully resolve difficult, conflict-oriented situations.

4. Highly effective verbal and written communication skills are necessary.

5. Highly proficient data analytic skills required. Ability to organize, combine, filter, and perform calculations on large datasets.

6. Highly effective computer skills that include the following applications: MS Excel, MS Word, and PowerPoint. Proficiency in Epic, MS Access, SAS, & Tableau is preferred.

7. Ability to handle confidential issues with integrity and discretion.

8. Ability to prioritize and manage work in a stressful environment.



What You Need to Be Successful:

IV. Education and Experience

1. Bachelor’s degree is required. Specialization in Healthcare, Finance, Accounting or equivalent related subject is preferred.
2. Four (4) years professional financial, reimbursement, or analysis experience is required.
3. Pervious supervisor or manager experience is preferred.
4. Healthcare-related finance background is preferred.

V. Knowledge, Skills and Abilities

1. Demonstrated knowledge of HSCRC reimbursement methodologies is required. Knowledge of state and federal reimbursement laws and regulations is required. Knowledge of ICD-10 and AMA Current Procedure Terminology (CPT) preferred. Proficiency in preparing and analyzing financial data and implementing changes to contain costs for budgetary purposes.

2. Effective at supervising, monitoring daily work activities, evaluating, training and motivating performance of subordinate technical, professional and clerical support staff.

3. Effective organizational and problem-solving skills are required to develop/implement efficient work processes and to successfully resolve difficult, conflict-oriented situations.

4. Highly effective verbal and written communication skills are necessary.

5. Highly proficient data analytic skills required. Ability to organize, combine, filter, and perform calculations on large datasets.

6. Highly effective computer skills that include the following applications: MS Excel, MS Word, and PowerPoint. Proficiency in Epic, MS Access, SAS, & Tableau is preferred.

7. Ability to handle confidential issues with integrity and discretion.

8. Ability to prioritize and manage work in a stressful environment.


We are an Equal Opportunity/Affirmative Action employer.  All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
Job ID: 68748
Help us improve CareerBuilder by providing feedback about this job: Report this Job.
CAREERBUILDER TIP
For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more.
By applying to a job using CareerBuilder you are agreeing to comply with and be subject to the CareerBuilder Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.
Don't miss out on new jobs like this
Get the latest jobs delivered to your inbox. Unsubscribe at any time.

Saving Your Job Alert

Job Alert Created

Well, this is embarrassing. We are having trouble saving your search. You can try again or come back at a later time.

Maximum Email Alerts

This email address has reached the maximum of 5 email alerts. To create a new alert, you will need to log into your email and unsubscribe from at least one.