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Clinical Director

4 months ago

Nashville, Tennessee, United States Allen Spolden Full time
Job Description
Essential Duties and Responsibilities:
  • Leverage data-mining and reimbursement modeling tools to review and identify underpayments/denials which are due for additional reimbursement from the payer
  • Identify and document underpayment root causes by contacting payers via phone and through review of client systems and account documentation
  • Submit written appeals detailing expected reimbursement and clearly outlining reasons for additional payment, including citation of contract language, policies, and industry standards in a persuasive manner
  • Gain knowledge of general hospital policies and procedures, hospital underpayments, and revenue cycle maximization opportunities
  • Ensures productivity and quality standards are met
  • Participate in internal client meetings, contributing to a greater understanding of project and initiative progress
  • Coaches/Partners with other team members
  • Identify and research new placement concept opportunities
  • Assist in client reporting
  • Strict adherence to HIPAA privacy and security rules, including following MRI policy at all times
  • All other duties as assigned
Requirements

Knowledge, Skills, Abilities:
  • Strong analytical, technical, and creative problem-solving skills
  • Demonstrated ability to analyze, understand, and communicate complex issues and trends.
  • Demonstrated interpersonal skills. Ability to articulate goals clearly and expectations to team members and communicate results to MRI Management.
  • Customer-service orientation with the ability to interact with a range of personalities independently and styles to establish effective relationships internally & externally.
  • A positive and optimistic attitude that is maintained despite tight deadlines and competing priorities.
  • Genuine enthusiasm for working for an evolving start-up with the ability to embrace new ideas.
  • Ability to demonstrate high personal ethics consistently, integrity, prudence, energy, initiative, and self-confidence.
Education/Experience:
  • Bachelor's degree with Healthcare, Business, or relevant background preferred
  • Relevant professional experience within the Hospital/Insurance industry preferred
  • Expertise within the MS Office Suite including Excel, Word, Outlook, and Access preferred
Benefits

Dental, Medical, Vision and 401K