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.
Headline : Dynamic Reimbursement Manager with over 7 years of experience in optimizing reimbursement processes and enhancing cash flow. Adept at analyzing complex billing issues and implementing solutions that drive efficiency and compliance. Passionate about fostering strong relationships with payers and internal teams to ensure seamless revenue cycle management.
Skills : Data Analysis Software, Team Leadership, Budgeting Skills, Customer Service
Description :
Oversaw billing for Managed Care, HMO, and Commercial insurance plans, ensuring compliance and timely collections.
Analyzed payer contracts to identify opportunities for improved reimbursement rates.
Collaborated with clinical teams to ensure accurate coding and documentation practices.
Monitored key performance indicators (KPIs) to drive departmental goals and objectives.
Facilitated training workshops for billing staff to enhance skills and efficiency.
Developed and maintained relationships with key stakeholders, including payers and vendors.
Led initiatives to enhance patient satisfaction through improved billing transparency.
Experience
5-7 Years
Level
Management
Education
B.S. HCA
Senior Reimbursement Manager Resume
Summary : Accomplished Senior Reimbursement Manager with a decade of expertise in streamlining reimbursement processes and maximizing revenue cycles. Proficient in navigating complex billing systems and enhancing payer relations. Committed to driving operational excellence and compliance while fostering collaboration across departments to achieve financial goals.
Analyzed billing discrepancies, conducting thorough investigations to validate overpayments and underpayments.
Facilitated refund processes, preparing all necessary documentation to ensure timely resolutions.
Conducted monthly accounts receivable meetings to review and strategize on aged accounts.
Evaluated patient credit status to determine eligibility for financial assistance programs.
Collaborated with cross-functional teams to streamline processes and improve revenue collection strategies.
Experience
7-10 Years
Level
Senior
Education
MBA
Reimbursement Manager Resume
Objective : Dedicated Reimbursement Manager with two years of experience in optimizing reimbursement workflows and enhancing financial performance. Skilled in resolving complex billing discrepancies and driving compliance with regulatory standards. Eager to leverage strong analytical skills and collaborative approach to improve revenue cycle management and support organizational goals.
Skills : Healthcare Regulatory Compliance, Medicare And Medicaid Reimbursement Strategies, Financial Auditing And Compliance, Patient Accounts, Financial Analysis, Data Analysis
Description :
Established billing department priorities and streamlined procedures to enhance operational efficiency.
Implemented performance metrics to ensure accuracy and exceptional customer service.
Created effective communication channels between billing vendors and internal teams to optimize information flow.
Designed and executed strategies to maximize reimbursement collections.
Formulated policies for managing exceptions, appeals, and denials.
Supervised daily operations of the billing department, focusing on accounts receivable management.
Reviewed client accounts to monitor performance and initiate corrective actions as necessary.
Experience
0-2 Years
Level
Junior
Education
B.S. Health Admin.
Reimbursement Manager - Level II Resume
Objective : Experienced Reimbursement Manager with 5 years of expertise in optimizing revenue cycle management and enhancing reimbursement processes. Skilled in addressing billing challenges and ensuring compliance with regulatory standards. Committed to building productive relationships with payers and internal stakeholders to drive financial success.
Supervised hospital staff in filing Medicare and Medicaid Cost Reports, maximizing revenue for services rendered.
Developed Excel models to import trial balances and summarize data for cost reports.
Collaborated with IT to automate Medicare Bad Debt Logs, enhancing efficiency.
Verified Medicaid eligibility, increasing DHS payments for the hospital.
Served on the Closing and Transfer Committee, ensuring smooth transitions during operational changes.
Improved documentation processes for $6 million in previously denied Medicare Bad Debt.
Monitored and achieved cash collection goals set by corporate, maintaining financial health.
Experience
2-5 Years
Level
Management
Education
BSHA
Reimbursement Manager Resume
Objective : Accomplished Reimbursement Manager with two years of experience in enhancing revenue cycle efficiency and ensuring compliance with regulatory standards. Proficient in resolving complex billing issues and optimizing reimbursement processes. Committed to leveraging analytical expertise and fostering collaborative relationships to drive financial performance and support organizational objectives.
Prepared Medicare and Medicaid cost reports for multiple hospitals, reconciling amounts due to/from programs.
Oversee reimbursement processes to ensure timely and accurate claims submissions.
Developed reimbursement accounting factors and logging system payment rates to optimize financial reporting.
Handled requests from internal auditors and government fiscal intermediary auditors, ensuring compliance.
Crafted electronic work papers for cost reports and monthly financial models, improving documentation efficiency.
Conducted quarterly on-site reviews of hospital exhibits and balance sheets for accuracy.
Enhanced proficiency in various information systems to streamline data capture for cost report preparation.
Experience
0-2 Years
Level
Entry Level
Education
B.S. in BA
Lead Reimbursement Manager Resume
Summary : Strategic Lead Reimbursement Manager with a decade of experience in optimizing revenue cycle operations and enhancing reimbursement accuracy. Skilled in resolving complex billing challenges and fostering relationships with payers to ensure compliance and efficiency. Committed to leveraging analytical expertise to drive organizational profitability and streamline reimbursement processes.
Skills : Risk Management, Health Information Systems, Claims Management Software, Training & Development
Description :
Oversaw the management of Medicare and commercial carrier claims, including submission, correction of insurance details, reconciliation, and denial appeals.
Executed electronic posting of all Medicare payments, enhancing efficiency and accuracy.
Delivered exceptional customer service, addressing all Medicare patient inquiries with professionalism.
Supervised the Check Out Department to ensure quality standards and resolve coding discrepancies.
Maintained up-to-date knowledge of CPT codes and Medicare guidelines, ensuring compliance across the organization.
Provided guidance to staff in resolving complex billing disputes, fostering a collaborative environment.
Communicated work procedures effectively to staff, ensuring clarity in operations and compliance.
Experience
7-10 Years
Level
Executive
Education
BSHA
Reimbursement Manager Resume
Headline : Seasoned Reimbursement Manager with 7 years of expertise in refining reimbursement strategies and optimizing revenue cycle operations. Skilled in navigating complex billing landscapes and establishing collaborative partnerships with payers to enhance financial outcomes. Driven to implement data-driven solutions that ensure compliance and maximize efficiency in revenue management.
Ensured adherence to billing procedures, optimizing revenue for treatment centers and enhancing financial performance.
Led a team of billing and financial staff, fostering a culture of accountability and excellence.
Negotiated favorable contracts with insurance carriers, maintaining strong payer relationships.
Monitored and evaluated payer contract performance to identify new opportunities for revenue growth.
Developed and maintained strong relationships with referring specialists to enhance revenue streams.
Managed electronic medical record systems to ensure accurate billing and compliance.
Implemented continuous improvement initiatives in billing and insurance processes, driving revenue enhancement.
Experience
5-7 Years
Level
Management
Education
B.S. in BA
Reimbursement Manager Associate Resume
Objective : Results-oriented Reimbursement Manager Associate with 5 years of specialized experience in optimizing reimbursement processes and enhancing cash flow. Proven ability to analyze billing discrepancies and implement effective solutions, driving compliance and operational efficiency. Dedicated to cultivating strong relationships with payers and stakeholders to ensure seamless revenue cycle management.
Skills : Interpersonal Skills, Process Improvement, Project Management, Technical Proficiency, Communication Skills, Problem Solving
Description :
Oversaw patient accounting, payment posting, and ICD-10 coding processes, billing a range of payers, and managing a $13 million annual revenue budget.
Led all phases of revenue cycle management, coordinating with billing, administrative, and clinical support staff to maximize accounts receivable.
Reviewed and negotiated managed care contracts, providing actionable recommendations to senior management.
Conducted training sessions for staff on compliance regulations and billing practices.
Completed credentialing applications for providers across multiple insurance plans, ensuring compliance with payer requirements.
Utilized medical coding expertise to manage the revenue cycle and process insurance claims efficiently.
Facilitated the completion of Medicaid and Medicare credentialing applications, improving provider access to reimbursements.
Experience
2-5 Years
Level
Entry Level
Education
B.S. Health Admin.
Reimbursement Manager Resume
Objective : Results-focused Reimbursement Manager with 5 years of experience in enhancing revenue cycle processes and ensuring compliance with industry regulations. Expert in resolving complex billing discrepancies and optimizing reimbursement strategies to maximize financial performance. Eager to leverage strong analytical skills and effective communication to foster partnerships that drive organizational success.
Oversaw a coding and medical billing office, implementing policies to maximize revenue and reimbursement efficiency.
Ensured compliance with government and commercial regulations through thorough documentation management.
Developed and executed charge policy recommendations in line with coding and reimbursement standards.
Conducted audits of physician coding practices, ensuring adherence to documentation requirements.
Coordinated team schedules to optimize resource allocation and workflow efficiency.
Managed personnel actions, including hiring and performance evaluations, to build a high-performing team.
Facilitated educational workshops for staff on coding and reimbursement best practices.
Experience
2-5 Years
Level
Consultant
Education
B.S. Health Admin.
Reimbursement Manager Resume
Summary : Reimbursement Manager with a decade of experience leading reimbursement strategies and optimizing revenue cycles. Expert in resolving billing complexities and enhancing payer relationships to ensure compliance and operational efficiency. Committed to implementing innovative solutions that drive financial performance and foster collaboration across healthcare teams.
Skills : Attention To Detail, Time Management, Workflow Optimization, Database Management, Claims Appeals
Description :
Managed the implementation of electronic billing systems, improving accuracy and efficiency in claims processing.
Negotiated reimbursement rates with insurance providers, resulting in increased revenue streams.
Analyzed financial impacts of new service offerings to support strategic decision-making.
Initiated the formation of specialized billing teams to enhance customer service and operational efficiency.
Collaborated with clinical and marketing teams to align service offerings with reimbursement strategies.
Provided leadership and training to staff, ensuring compliance with billing regulations and best practices.
Conducted regular cash reconciliations to maintain financial integrity across accounts receivable.
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