Director of Reimbursement Job in Boston 02126, Massachusetts US

The Director of Reimbursement reports to the Executive Director/Corporate Vice President for the Elder Service Plan, collaborates with management within Harbor Health Services Corporate Finance Department and is responsible for assuring accurate fiscal operations of the Elder Service Plan, a Medicare/Medicaid program.

Responsibilities include but are not limited to: oversight of all fiscal operations; ensuring complete reimbursement for all enrolled participants; analysis and implementation of interventions to ensure accurate reimbursement; managing process for annual Medicare Part D bid; implement and ensure the timely response of requisite fiscal reporting and ad hoc fiscal reports; managing payables and accruals; ensuring compliance with all fiscal requirements and regulations; developing and implementing processes/proposals for improved reimbursement and payables; managing fiscal audits; functioning as Compliance Officer for Medicare; act as project manager for the review, development and implementation for electronic claims receipt and submission including ICD 10 conversion as well as encounter data reporting; and providing direct supervision and management of ESP Fiscal Department staff.

Minimum Skills, Experience and Educational Requirements:
Master’s degree in related field or MBA with concentration in health management,
minimum of five years’ experience in healthcare finance at a managerial level and of which one year was as the direct supervisor of professional staff,
proficiency with Microsoft applications specifically Excel, Word, Outlook and Access,
proficiency and knowledge of data bases and use of,
proven knowledge of healthcare reimbursement principles including Medicare and Medicaid,
proven ability to analyze diverse sets of information and to prepare and execute an action plan of problem identification and resolution,
excellent verbal and written communication skills communicating with a wide audience (e.g. physicians, senior managers, patients, finance staff) on sometimes complex problems,
excellent problem solving skills,
highly organized to handle multiple tasks simultaneously under sometimes tight deadlines,
ability to take initiative; work independently and as a team player,
ability to handle sensitive and confidential patient and employee information.


Substitutions for Skills, Experience and Education:
4 -5 years of related management work healthcare experience for the Master’s Degree
 
Preferred Skills, Experience and Educational Requirements:
Experience in hospital billing,
proven knowledge in data base systems and interface development,
three or more years of supervisory experience preferred,
knowledge of diagnostic coding,
experience with Medicare Part D prescription drug benefit and managed care preferred,
experience in developing Access data bases.

Supervisory Responsibilities:
ESP Finance Staff

For more information please call 617-533-2300.