Reimbursement and Billing Director
3 weeks ago
Job Description
Job Description Description: The Reimbursement and Billing Director oversees Benefits Investigation (BI) and Field Reimbursement and is responsible for the strategic development of building a highly functional reimbursement team that improves our value proposition for our customers. This includes collecting and implementing improvement opportunities, solving customer-related reimbursement issues, proactively training customers on Kerecis reimbursement, providing reimbursement training to our salesforce, and creating standard operations that can be managed using Key Performance Indicators. The Director manages the team supervisors, who in turn are responsible for reimbursement issues pre-application and supporting client billing issues post-application, respectively.
An essential member of the Wound team, the Director reports to the COO and works in close collaboration with senior Wound Sales management with the clear goal of supporting revenue growth through reimbursement support to field sales.
This full-time role is based on site in a Kerecis office.
Responsibilities
Oversee the entire reimbursement process from inbound BIs to billing and reimbursement.
Coordinate and align the BI and FR teams to optimize and synchronize results for Sales, clients, and patients
Ensure the teams are fully and properly trained
Ensure sufficient staffing of the BI and FR teams commensurate with the growth of the Wound sales team and client base
Ensure proper usage of Fishurance, Kerecis Current, and other internal systems
Ensure that turnaround times align with determined metrics; establish new metrics as needed
Coordinate with the Policy team to adjust investigations with policy changes
Ensure that the teams follow up rapidly on any issues or complaints from any stakeholders, including clients and Sales
Ensure HIPAA compliance within the BI and FR teams
Benefits Investigations
Oversee the BI supervisor
Coordinate with the Artificial Intelligence (AI) developer to ensure that the AI engine is updated and maintained
Field Reimbursement
Oversee the FR supervisor
Advise the Policy team on suggestions and changes noted in the field
Train clients on Kerecis Current
Increase adoption of Kerecis Current
Assist clients for accurate billing of Kerecis products
Manage the FR team to do client visits, business reviews, etc.
For identified Enterprise Accounts, create and implement a proactive enterprise billing review program
Requirements: Competencies
Experience with Medicare and private insurance reimbursement
Experience in the Skin Substitute a plus
Education & Experience
Bachelor’s degree or equivalent experience
Experience managing managers and detailed processes
Experience in customer service and other client facing roles
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibili¬ties that are required of the employee for this job. Duties, responsibilities and activities may change at any time. Kerecis is an equal opportunity employer.
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