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Reimbursement Director

San Antonio, TX, United States
Full-time  No Weekends 
Category: Directors and Managers • Job ID: 20798-93847

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Description

SHIFT: No Weekends

SCHEDULE: Full-time

Do you have the career opportunities you want in your current role? We have an exciting opportunity for you to join the nation's largest provider of healthcare services as a Reimbursement Director.


HCA Healthcare is a national leader in providing modern, culturally competent, patient-centered care and we are driven by a single goal: the care and improvement of human life. We offer you an excellent total compensation package, including competitive salary, excellent benefit package and growth opportunities. We believe in our team and your ability to do excellent work with us. Your benefits include 401k, PTO medical, dental, flex spending, life, disability, tuition reimbursement, employee discount program and employee stock purchase program. 


We would love to talk to you about this fantastic opportunity. The HCA Physician Services Group (PSG) is the physician and practice management solution for HCA Healthcare. We lead a collection of highly motivated healthcare professionals just like you and creative leaders who are committed to excellence in every patient interaction. Are you excited yet?


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We are seeking a Reimbursement Director for our San Antonio Division. In this role you will direct and coordinate activities of employees engaged in revenue cycle activities including reception, data entry, insurance verification/preauthorization, self-pay policies and processes-front end and back end, physician query processes, denial analysis, coding analysis, fee schedule analysis and maintenance, insurance company reimbursement analysis. The objective of this position is to increase collections through detailed analysis and process improvement working together with local receptionists, cash posters, business office staff and management as well as with the central business office, coding and managed care dependents. Assess current E&M coding analysis reports; utilize if adequate; if not, enhance it or create E&M bell curve coding analysis tool; determine appropriate way to ensure physicians are documenting and coding properly. Work with coding and compliance departments as needed and always ensure appropriate compliance. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. 


Additional Responsibilities include (but not limit to):

  • Function as liaison to Central Business Office and communicate regularly with them working together to improve division days in A/R, collections, decreased denials and other dashboard indicators.

  •  Work with other staff such as receptionists and others in the practices that have revenue cycle responsibilities, in coordination with their managers, to provide training, auditing of work, process improvement, etc.

  • Oversees the timely and accurate data entry of charges.

  •  Assesses self-pay policies, improve them as needed; implement reception audits and other processes to improve self-pay front end and back end collections.

  • Assesses preauthorization policies and processes and change as needed to decrease denials.

  • Analyze denials on a monthly basis and implement processes to decrease denials by focusing on top denial reasons.

  • Analyze fee schedules and modify as needed to appropriate reimbursement.

  • Analyze enrollment processes and work with enrollment department to improve timeliness of completed enrollment and to minimize claims to hold and enrollment related denials.

  • Analyze insurance contract reimbursement and work with managed care department and local managed care contracting staff to improve reimbursement and contract language terms where possible. Includes assessment of current EOB analysis and other data analysis that may already being done by the managed care department; use data already available and where there are gaps, perform analysis needed.

  • Regularly review AR data and develops strategies to improve revenue. Use A/R standards (dashboards) where already established or establish those that do not exist; monitor and report on them monthly with action plans for improvement where needed.

 

 


 

 

Qualifications

What Qualifications you will need:

  • Bachelor’s degree or equivalent combination of education and/or experience.
  • At least three to five years of medical billing experience along with prior supervisory experience with prior supervisory experience of at least three years.
  • Experience with practice management operations and front end processes
  • Comprehensive understanding of the revenue cycle from preauthorization to receptions to coding, to charge entry to billing to back end claim follow up is required.
  • A comprehensive knowledge of CPT & ICD.9 coding is desired.
  • High proficiency to perform detailed data analysis, identify trends, improve processes and establish processes and guidelines for staff.
  • Strong financial acumen and revenue integrity  
  • Ability to analyze and interpret general business periodicals, professional journals, technical procedures or governmental regulations and compose reports, business correspondence and procedure manuals. 

HCA Healthcare ranks on Fortune’s list of Most Admired Companies for three consecutive years and HCA ranks 63rd on the Fortune 500 list. In addition, Ethisphere named HCA as one of the World’s Most Ethical Companies. We want you to join our tradition of excellence. Intrigued? We’d love to hear from you.


If you find this opportunity compelling, we encourage you to apply. We promptly review all applications. If you are highly qualified, you will hear from one of our Practice Managers. We are actively interviewing so apply today.


We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Notice

Our Company’s recruiters are here to help unlock the next possibility within your career and we take your candidate experience very seriously. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Gmail or Yahoo Mail. If you feel suspicious of a job posting or job-related email, let us know by clicking here.

For questions about your job application or this site please contact HCAhrAnswers at 1-844-422-5627 option 1.

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