• Reimbursement Supervisor

    Location US-MD-Columbia
    Job ID
    2018-1268
    # Openings
    1
    Category
    Reimbursement
  • Primary Purpose of Position

    In addition to the execution of the core Reimbursement Supervisor functions listed below, the Reimbursement Supervisor must possess an elevated awareness of his/her responsibility to the team and obligation to the team’s ongoing functioning and overall performance. This elevated responsibility will be demonstrated with the following: research and resolution of escalated issues, assistance with training, auditing cases, effective and strong communication with the Sales Team, payer research, and completion of special projects as assigned by Associate Director. The Reimbursement Supervisor will support both RTLs and assist with tasks for either RS or RCA with minimal direction from the Associate Director to support the team. The Reimbursement Supervisor will respond to all provider account, patient, and internal inquiries in a timely fashion and document all interactions consistently. The Reimbursement Supervisor is also responsible for providing thorough evaluation of staff performance and recommending sound solutions to meet business needs.

    Principal Responsibilities

    • Represents as the main point of contact for the Hotline team
    • Demonstrates leadership and provides support to the team to ensure all service level agreements are met on a consistent basis.
    • Identify any barriers to work flow efficiencies, ex. Insurance Verification Turn Around Time
    • Identify any need for additional staffing to meet business needs
    • Assist with training staff on any new coverage/policies on a consistent basis
    • Respond to all Sales and RAM inquiries in a timely manner
    • Set daily priorities and expectations for the staff
    • Monitor all staff performance (Goals, Attendance, Overall Performance)
    • Working with Clinical Case Manager to educate staff on identifying and understanding payer coverage criteria requirements for all prior authorizations and pre-determinations.
    • Completes monthly staff audits and provides direction for any correction and future improvement.
    • Analyzes data and draws valid and logical conclusions based on information provided by insurers and documented medical policies.
    • Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
    • Prioritizes duties and tasks as necessary to ensure assignments are completed in a timely fashion. Reports any reimbursement trends/delays to Associate Director.
    • Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercise judgment within defined standard operating procedures to determine appropriate action
    • Performs related duties as assigned.

    Qualifications

    • Biotechnology or Pharmaceutical background in Hub Industry or Reimbursement
    • Competent with strong problem solving
    • Strong knowledge of Microsoft Word, Excel, Power Point and Outlook
    • Ability to interact professionally at multiple levels within a client oriented organization
    • Excellent organizational, written and verbal communication skills
    • Ability to manage multiple and varied tasks, and prioritize workload
    • Ability to work professionally with highly confidential information
    • Experience with Microsoft based applications, and ability to learn internal computer systems
    • Flexibility and ability to adjust to changing priorities and unforeseen events; excellent time management skills
    • Ability to work consistently in a fast-paced environment
    • Previous coding and billing experience in provider office or hospital setting
    • Strong quality orientation including the ability to focus on details and adherence to standards while ethically maintaining a business perspective
    • Able to handle high pressure situations and constructively resolve potential conflicts

    Required:

    Experience in Reimbursement in healthcare industry

    Preferred:

    • Four year college degree
    • Reimbursement experience within a call center environment

    Related Work Experience:

    • 1-3 years of customer service and reimbursement experience within the biotechnology or pharmaceutical industry
    • Knowledge of Medicare, Medicaid, and Private Insurer Reimbursement Methodology
    • Able to interpret and analyze detailed Medical policies
    • Basic understanding of the benefits investigation process [deductible, out of pocket, benefits exclusions, etc.]
    • Familiar with ICD 10 Coding
    • Familiar with Wound Care

     

    Osiris Therapeutics, Inc. is an Equal Opportunity Employer with a commitment to diversity. Applicants are considered on the basis of individual merit without regard to race, color, national or ethnic origin, gender, gender identity, sexual orientation, marital status, veteran status, pregnancy, age, religion, disability, genetic information, or any other characteristic protected by law.

     

     

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