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Physician Services Manager - Claims - Cincinnati Area #3574

Absolute Opportunities
Cincinnati, Ohio, United States
April 28, 2017

Position Title Physician Services Manager - Claims - Cincinnati Area #3574

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 members

Coach, 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 guidelines

Plan and allocate resources to appropriately staff each assignment

Evaluate and improve departmental operating procedures to enhance speed, quality, efficiency, and overall effectiveness

Track various departmental information in order to develop and maintain benchmarks, create goals, manage trends, identify areas of opportunity and weakness, identify issues and training opportunities

Participate in workflow examination or special projects as needed

Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment posting

Examine 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 needed

Maintain regular contact with necessary parties regarding project status including clients, managers, and other personnel

Build strong, lasting relationships with clients, payors and company personnel

Organize, prepare and/or attend department, client and company meetings

Comply with federal and state laws, company policies and procedures

Essential Skills and Experience:

Minimum 5-years Management experience

Minimum 3-years Coding experience, with certification

Excellent interpersonal skills with proven ability to motivate and lead a team

Ability to communicate at a professional level, orally and in writing (in English)

Strong customer service orientation

Experience preparing and presenting information at an Executive level

Moderate to advanced Microsoft Excel

Moderate Microsoft Word

Moderate computer proficiency

Mathematical skills: ability to calculate rates using addition, subtraction, multiplication and division

Ability to read and interpret an extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram form

Ability to define problems, collect data, establish facts and draw valid conclusions

Strong team player

Commitment to company values

High school diploma or equivalent

Ability to travel by automobile or public transportation to visit or setup work sites

Nonessential Skills and Experience:

Auditing experience is a plus

Related Professional License/Certifications

Associate or Bachelor's Degree

Reporting To This Position: Physician Services Analysts

Bottom line requirements we need notes on with candidate submittal:

1. Associate's or Bachelor's Degree preferred.

2. 5 + years of Management experience.

3. 3+ years of Coding experience.

4. Certified Professional Coder.

5. Local or close enough for a short easy move.

6. Auditing experience is a plus.