Reimbursement Manager Resume Samples

The Reimbursement Manager in a healthcare setting will handle a variety of tasks including providing reimbursement, monitoring cost reports, and maintaining medical records. Typical work activities seen on the Reimbursement Manager Resume include the following – developing strategies and supporting customers with their reimbursement issues; managing all transactions, training executive staffs on new policies; assisting in the preparation of the department’s budget; negotiating contracts with vendors and consultants; and taking responsibility for tracking all medical reimbursement files.

Employers pick resumes that denote the following skills – strong analytical skills, comfortable in analyzing financial data and interpreting cost reports; good communication skills, the ability to build a relationship with medical staff and health care professionals; and strong knowledge of using relevant software programs. Successful resumes denote a degree in the field of healthcare administration, business or a related field.

Reimbursement Manager Resume example

Reimbursement Manager Resume

Summary : Extremely successful achieving Cash Collection Goals, often resulting in bonuses for staff. Always focused on providing outstanding Customer Service when dealing with collections.

Skills : MS Office, Excel, Power Point.

Description :

    1. Managed all aspects of the revenue cycle for a home infusion/specialty medication pharmacy.
    2. Managed Care, HMO, and Commercial insurance plans.
    3. Responsible for posting cash in excess of $1 million per month to open AR accounts.
    4. Performed daily and monthly cash reconciliation to balance the computer system with accounts receivable.
    5. Investigated all overpayments and underpayments to determine validity.
    6. Performed refunds including preparing all necessary paperwork.
    7. Conducted monthly AR meetings to review all aged accounts.
    8. Assessed patient's credit to determine indigence.
    9. Responsible for meeting all cash, aged AR and bad debt reserve goals established by our corporate office.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Master Of Business


Sr. Reimbursement Manager Resume

Summary : Proven effectiveness and confidence in environments requiring handling of multiple tasks, while maintaining accuracy and confidentiality. Strong orientation to detail and organization.

Skills : Microsoft Office, Quickbooks, 10-key Pad.

Description :

    1. Managed all aspects of the revenue cycle for a home infusion/specialty medication pharmacy.
    2. Responsible for posting cash in excess of $1 million per month to open AR accounts.
    3. Performed daily and monthly cash reconciliation to balance computer system with accounts receivable.
    4. Investigated all overpayments and underpayments to determine validity.
    5. Performed refunds including preparing all necessary paperwork.
    6. Conducted monthly AR meetings to review all aged accounts.
    7. Assessed patient's credit to determine indigence.
    8. Responsible for meeting all cash, aged AR and bad debt reserve goals established by our corporate office.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Master Of Business


Jr. Reimbursement Manager Resume

Summary : Results oriented professional seeking a challenging leadership role that fully utilizes creativity, strong analytical ability, presentation skills and expertise in providing medical accounts receivable insight, direction and process training development.

Skills : Regulatory Compliance, Medicare Coverage And Reimbursement Systems, Internal Auditing, Enterprise Risk Management.

Description :

    1. Developed all billing department's priorities, procedures, and policies.
    2. Determined appropriate and effective performance metrics and staff requirements for the department to run with efficiency, accuracy and outstanding customer service.
    3. Developed processes and procedures for the efficient and successful flow of interdependent information between the third party billing vendor, the receivables department and the Client billing office.
    4. Designed and executed key strategies to drive the collection of earned reimbursement.
    5. Developed processes and policies for exception handling, appeals and denials, and balance billing.
    6. Managed the daily performance of the billing department and all accounts receivable operations.
    7. Monitored all client accounts receivable activity and performance and initiates appropriate corrective measures as needed.
    8. Monitored billing compliance with all third party payer regulations.
    9. Ensured that customer satisfaction is achieved through courteous and effective communication, problem-solving and efficient processes.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
MBA In Finance

Reimbursement Manager II Resume

Summary : Extensive experience in small rural hospitals and the healthcare reimbursement, and proven abilities in documentation, computer systems, contract negotiations, financial reporting, and bank relationships.

Skills : Microsoft Office, McKesson, Cerner, Medicare And Medicaid Knowledge.

Description :

    1. Supervised and consulted with Hospital Staff for filing Medicare and Medicaid Cost Reports, and collecting the maximum appropriate amounts for services rendered.
    2. Created an Excel Model for importing Hospital's Trial Balances and summarizing the data into the Cost Report Formats.
    3. Assisted IT in developing automatic Medicare Bad Debt Logs.
    4. Verified Medicaid eligibility to increase DHS Payments.
    5. Serviced on the Closing and Transfer Committee for moving St.
    6. Improved documentation on $6,000,000 of Medicare Bad Debt that was already denied in earlier Cost Reports.
    7. Responsible for meeting all cash, aged ar, and bad debt reserve goals established by our corporate office.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
AAS In Accounting

Reimbursement Manager I Resume

Summary : Results-driven professional with extensive experience in Reimbursement Manager and collections management.

Skills : Microsoft Office, Medical Billing, Management.

Description :

    1. Responsible for preparing Medicare & Medicaid cost reports for four hospitals in the markets, and accounting for the amounts due to or from the programs.
    2. Compiled the Medicaid eligible patient days for DSH, for Gulf Coast Division hospitals.
    3. Prepared hospitals' reimbursement accounting factors, budget reimbursement factors, and logging system payment rates.
    4. Responsible for handling requests of the Company's internal auditors and government program fiscal intermediary auditors.
    5. Crafted electronic work paper sets for cost report work papers, year-end trial balances, and monthly exhibit models.
    6. Performed quarterly on-site reviews of hospitals' exhibits and cost report related balance sheets and P&L accounts.
    7. Developed proficiencies with various information systems in order to efficiently capture data needed to prepare and account for hospital cost reports.
    8. Trained other Reimbursement professionals on Department systems.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Bachelor Of Business

Associate Reimbursement Manager Resume

Summary : Highly qualified Reimbursement Manager with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and the collaborative environment on which your company prides itself.

Skills : Project Management, EPIC, Misys Scheduling System, Certified Coder.

Description :

    1. Managed Medicare and commercial carrier claims to include submission, correction of insurance and demographic information, claims reconciliation and denial appeals.
    2. Posted all Medicare payments electronically.
    3. Provided high quality customer services to all Medicare patient questions.
    4. Supervise the work of the Check Out Department to ensure adherence to quality standards, proper procedures, and correcting coding errors or problems.
    5. Maintained awareness and keep Providers informed of all updated CPT codes and changes in Medicare guidelines and health insurance changes.
    6. Provided employees with guidance in handling difficult or complex problems and in resolving billing disputes.
    7. Interpreted and communicated work procedures and company policies to staff.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Diploma

Reimbursement Manager III Resume

Summary : Professional with more than 22 years of Reimbursement Manager experience and success in the healthcare environment in Financial roles with a focus on Business Operations, Business Development and Consolidations, planning and forecasting, financial reporting policies, procedures, operations analysis, audit management, staff management and training.

Skills : Business Management, Intelligence.

Description :

    1. Ensured all billing procedures followed according to standard operating procedures to maximize treatment center revenue.
    2. Provided exemplary leadership to all billing, insurance and financial counseling staff.
    3. Negotiated contracts with Insurance carriers maintaining appropriate communication with payers, sustaining positive and mutually beneficial relationships.
    4. Monitored payer contract performance and provide evaluation of potential contracting opportunities.
    5. Maintained positive and loyal relationships among referring specialists.
    6. Maintained database files in department electronic medical record.
    7. Offered and implemented continuous improvement ideas for billing and insurance areas to enhance revenue.
    8. Provided support and assistance to staff encouraging optimal performance and maintain compliance with standardized operating procedures and governmental regulations.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Medical Terminology

Reimbursement Manager/Supervisor Resume

Summary : Recognized as consistently surpassing company expectations regarding payer issues, claims resolutions, cash collections, billing issues & inquiries with a strong drive to succeed. Goal oriented and results driven, specializing in analyzing data, identifying reimbursement trends and developing creative solutions to improve profitability.

Skills : Accounting Knowledge, Excel - Hyperion.

Description :

    1. Responsible for patient accounting, payment posting, and ICD9 coding processes while billing Medicaid, Medicare, HMOs and third-party payers for behavioral health service consumers collecting annual revenue of a 13 million dollar budget.
    2. Responsible for all phases of revenue cycle management, familiar with EDI 5010 set up of claim testing, client registrations, maximizing account receivables, coordinating activities with billing, administrative, credentialing license staff with a variety of insurance Thivierge 2 of 3 payers, and clinical support.
    3. Managed care contracts while making recommendations to management.
    4. Responsible for educating and training staff on issues related to compliance regulations and some behavioral coding issues.
    5. Completed credentialing apps for license staff for Medicare, Medicaid, VA Options, CHAMPUS, Federal Health Net, Optima, Magellan, VA Options, CIGNA, and VA Premier.
    6. Managed the revenue cycle plus use medical coding experience related to processing a variety of insurance claims.
    7. Completed Medicaid and various insurance credentialing applications plus experience with Medicare PECOS and 855 hard copy applications.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Bachelor In Health

Reimbursement Manager/Consultant Resume

Summary : Seeking an opportunity to interview within your organization. Looking for a position that will allow to broaden and share knowledge and experience in various institutions, as it pertains to reimbursement and coding.

Skills : Software Architecture, E-Commerce.

Description :

    1. Managed a coding/medical billing office, initiate, implement and monitor policies and procedures to provide maximum billing and reimbursement revenue for the section.
    2. Maintained supporting documentation and ensure compliance with government, managed care, and commercial regulations.
    3. Initiated and implemented charge policy recommendations relative to coding and reimbursement guidelines.
    4. Conducted periodic audits of physicians and staff for proper coding and documentation.
    5. Planned and scheduled work for the group ensuring proper distribution of assignments and adequate man-power, space and facilities for performance duties.
    6. Supervised various personnel actions including, but not limited to hiring, performance appraisals, promotions, transfers, and vacation schedules.
    7. Conducted informative and educational meetings for the staff on coding, documentation, and reimbursement issues.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Bachelors In Business

Reimbursement Manager Resume

Objective : Seeking a Reimbursement Manager position at a company in need of an individual to serve in a leadership role in an environment which promotes professional growth and opportunity.

Skills : Admissions Manager, Finance, Education.

Description :

    1. Managed two computer conversions in Patient Accounts and implemented electronic billing software to replace paper billing.
    2. Negotiated case management rates with insurance companies including the first Infusion Services contract with Anthem Insurance Company.
    3. Evaluated the financial and clinical impact of a hemophilia factor program to determine the feasibility of adding this service.
    4. Conceived Customer Service Billing Team and Respiratory Services/Billing Team.
    5. Facilitated for Clinical Monitoring Team and member of Marketing Team, Hospice Team, and Fixed Asset Team.
    6. Worked with minimal guidance and no supervision as the direct supervisor was located in a different city.
    7. Performed daily and monthly cash reconciliation to balance the computer system with accounts receivable.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Certified Medical