Clinical Reimbursement Manager - Full-Time
Could you be our next Clinical Reimbursement Manager - UR?
Why work as a Clinical Reimbursement Manager with Main Line Health?
- Make an Impact! Your leadership makes a difference! Our Clinical Reimbursement Manager-UR reviews all clinical assessment (OASIS) and plans visit based on the care needs of the client and the reimbursement to be received by the agency for providing this care. You will be responsible for overseeing and evaluating the services provided to home health clients to maximize clinical outcomes, financial profitability, and regulatory compliance. You will use your expertise in making these decisions in collaboration with the payor as needed by reviewing the profit and loss of each client taken under care and the ability of the client/caregiver to support care in the home. You will also ensure the proper ICD-10 coding, oversee the progress of the client during the home health admission, monitor care events that may trigger a change in care needs, manage an average active caseload of 100-150 clients (1500 clients annually) and monitor the activity of 200 clinical staff.
- Develop and Grow your Career! Invest in furthering your education through seeking certifications or advanced degrees by taking advantage of our Tuition Reimbursement! This position is eligible for up to $6,000 per year based upon your Full or Part Time status.
- Join the Team! Like our patients, the Main Line Health Family encompasses a wide range of backgrounds and abilities. Just as each of our patients requires a personalized care plan, each of our employees, physicians, and volunteers, bring distinctive talents to Main Line Health. Regardless of our unique design, we all share a purpose: providing superior service and care.
- Position-Specific Benefits include: You are eligible for hours of paid time off per year based on your Full or Part Time status. We also offer a number of employee discounts to various activities, services, and vendors... And employee parking is always free!
Shift: M-F
Experience:
1. Three to five year’s clinical experience with at least two years home care experience required.
2. Basic computer skills required, knowledge of home health information system a plus
3. Knowledge of Medicare regulations pertaining to Home Health, expertise in Home
4. Health Coding preferred.
Education:
1. Graduate of an accredited School of Nursing required.
2. Associate’s degree required.
3. Bachelor’s degree preferred.
Licensures/Certifications:
1. Current licensure in the Commonwealth of Pennsylvania as a Registered Nurse required.
2. Valid driver’s license and insured automobile required.
3. Home Care Coding Specialist Certification as described above required.
If this position offers an Employee Referral Bonus (listed below), please note that all Referral Bonus dollars are pro-rated for positions hired less than 80 hours per pay period. For further details, visit the Employee Referral Program located on Wellspring.
Main Line Health (MLH) with over 10,000 employees, is suburban Philadelphia's most comprehensive health care resource, offering a full range of healthcare services. Learn more about us.
Main Line Health is committed to the health and wellness of our employees. We offer competitive salaries, comprehensive benefits, generous paid time off, 403b savings plan, lucrative pension plan, tuition reimbursement, and more! Learn more about our benefits.
We are an EOE/Veterans/Disabled/LGBTQ employer. Main Line Health celebrates our differences and our similarities. Learn more about our Diversity and Inclusion culture.