Clinical Director

Allen Spolden • Full-time • Nashville, Tennessee • 17m ago

Essential Duties and Responsibilities:<\/span><\/b>
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<\/span><\/div>Leverage data -mining and reimbursement modeling tools to review and identify underpayments/denials which are due for additional reimbursement from the payer<\/span>
<\/span><\/li>Identify and document underpayment root causes by contacting payers via phone and through review of client systems and account documentation<\/span>
<\/span><\/li>Submit written appeals detailing expected reimbursement and clearly outlining reasons for additional payment, including citation of contract language, policies, and industry standards in a persuasive manner<\/span>
<\/span><\/li>Gain knowledge of general hospital policies and procedures, hospital underpayments, and revenue cycle maximization opportunities<\/span>
<\/span><\/li>Ensures productivity and quality standards are met<\/span>
<\/span><\/li>Participate in internal client meetings, contributing to a greater understanding of project and initiative progress<\/span>
<\/span><\/li>Coaches/Partners with other team members<\/span>
<\/span><\/li>Identify and research new placement concept opportunities<\/span>
<\/span><\/li>Assist in client reporting<\/span>
<\/span><\/li>Strict adherence to HIPAA privacy and security rules, including following MRI policy at all times<\/span>
<\/span><\/li>All other duties as assigned<\/span>
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Requirements<\/h3>

Knowledge, Skills, Abilities:<\/span><\/b>
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<\/span><\/div>Strong analytical, technical, and creative problem -solving skills<\/span>
<\/span><\/li>Demonstrated ability to analyze, understand, and communicate complex issues and trends.<\/span>
<\/span><\/li>Demonstrated interpersonal skills. Ability to articulate goals clearly and expectations to team members and communicate results to MRI Management.<\/span>
<\/span><\/li>Customer -service orientation with the ability to interact with a range of personalities independently and styles to establish effective relationships internally & externally.<\/span>
<\/span><\/li>A positive and optimistic attitude that is maintained despite tight deadlines and competing priorities.<\/span>
<\/span><\/li>Genuine enthusiasm for working for an evolving start -up with the ability to embrace new ideas.<\/span>
<\/span><\/li>Ability to demonstrate high personal ethics consistently, integrity, prudence, energy, initiative, and self -confidence.<\/span>
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Education/Experience:<\/span><\/b>
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Bachelor’s degree with Healthcare, Business, or relevant background preferred<\/span>
<\/span><\/li>Relevant professional experience within the Hospital/Insurance industry preferred<\/span>
<\/span><\/li>Expertise within the MS Office Suite including Excel, Word, Outlook, and Access preferred
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