Job Information
West Michigan Community Mental Health Reimbursement Coordinator in Ludington, Michigan
The Reimbursement Coordinator is a professional level position that works as a member of the Finance Team. The duties of this position are to provide leadership and supervision of the Reimbursement Team members and ensure claims reporting quality, accuracy, and timeliness. The Reimbursement Coordinator will partner with the Billing Coordinator to lead billing and reimbursement functions of the organization. Responsible for staying current with and following guidelines set forth by Department of Community Health, legislature, Medicaid, Medicare, Blue Cross and other payers.
The position incumbent will perform the above duties while working collaboratively with individuals across all organizational teams. Work may include, but is not limited to, data management, participating in workgroups, corresponding with the State, assisting with research, analysis, and recommendation development for various claims or financial projects. Responsible for attending meetings with MDHHS, LRE, payors, and community partners to ensure WMCMH stays current with developing changes at the national, state, and local levels.
Job Duties:
- Coordinates reimbursement activities in accordance with Medicaid and other payer obligations and requirements
- Responsible for staying current with and following guidelines set forth by Department of Community Health, legislature, Medicaid, Medicare, Blue Cross, and other payers.
- Ensure claims reporting quality, accuracy, and timeliness.
- Responsible for establishment and maintenance of security controls, accuracy, and integrity of the claims data
- Ensures adequacy of team to support claims management responsibilities for internal and external providers.
- Provides input on claims processing policy and procedures.
- Establishes appropriate code, modifier, and discipline setup to ensure compliance with requirements.
- Participates with agency efforts toward workflow and electronic medical record efficiencies while maintaining financial and operational practices that follow insurance billing guidelines.
- Provide outstanding supervision and leadership to reimbursement team members.
- Responsible for timely review of outstanding claims to ensure maximum reimbursement.
- Responsible for assisting in providing accurate costs for services and rate determination.
- Responsible for assisting with various insurance application enrollments for new staff providers. Maintain provider matrix by insurance type and coordinate with UM to ensure matrix is current and accurate