Full-Time Reimbursement Supervisor-Patient Accounting

Ashe Memorial Hospital•Jefferson, NC

1d•Onsite

About The Position

The Reimbursement Supervisor is responsible for supporting the organization’s revenue cycle through comprehensive oversight of revenue integrity processes, denial prevention and resolution, and Charge Description Master (CDM) maintenance and optimization. This position serves as a key resource in identifying revenue leakage, ensuring compliance with regulatory and payer requirements, improving charge capture accuracy, and collaborating with operational departments to strengthen reimbursement outcomes. This role will act as a subject matter expert, provide guidance on departmental operations, manage, supervisor and train assigned team members. This role will assist with analysis for third-party reimbursement to ensure payer contract compliance. The role functions as a liaison among Revenue Cycle, Coding, Clinical Departments, Pharmacy, Laboratory, Materials Management, and Finance to ensure accurate billing practices, compliant charging workflows, and effective denial mitigation strategies.

Requirements

Associate degree in Healthcare Administration, Business, Finance, Health Information Management, or related field.
Minimum of 3–5 years of revenue cycle, billing, coding, denial management, or revenue integrity experience in a healthcare setting.
Experience with CDM maintenance and billing compliance is highly preferred.

Nice To Haves

Bachelor’s degree preferred.
Critical Access Hospital or hospital-based experience preferred.
Certified Revenue Cycle Representative (CRCR)
Certified Coding Specialist (CCS) or Certified Professional Coder (CPC)
HFMA Revenue Cycle Certification
Revenue Integrity Certification preferred
Employees hired without a certification may be to obtain an approved certification with twelve (12) months of hire.

Responsibilities

Monitor charge capture to identify missed revenue, billing errors, and compliance issues.
Audit charge processes, Charge Description Master (CDM), and reimbursement methods.
Review charging workflows to ensure accurate and compliant billing.
Identify revenue leakage trends and recommend process improvements.
Evaluate payer contracts, reimbursement rates, and payment methodologies.
Provide analytical support for managed care contract negotiations and maintenance.
Review and resolve denied or underpaid claims.
Analyze denial trends and implement corrective actions.
Work with Coding, Billing, Clinical departments, and payers to resolve claim issues.
Stay current on payer regulations affecting reimbursement.
Assist with appeals and supporting documentation.
Maintain the accuracy and integrity of the hospital CDM.
Ensure compliance with CPT, HCPCS, ICD-10, revenue codes, modifiers, and payer requirements.
Coordinate annual and ongoing CDM updates.
Partner with departments to add new services, supplies, medications, and procedures.
Verify pricing, revenue codes, and charge mappings.
Lead and participate in semiannual CDM reviews with departments including Materials Management, Laboratory, Pharmacy, Coding, Same Day Care, Rehabilitation, Emergency, Inpatient, and Outpatient Services.
Serve as a resource for charging, billing, reimbursement, and documentation questions.
Ensure compliance with federal, state, payer, and organizational billing regulations.
Prepare reports on denials, revenue integrity audits, and CDM findings.
Track trends, corrective actions, and financial outcomes.
Support revenue cycle improvement initiatives.
Complete required orientation and training.
Follow facility policies and OSHA safety standards.
Maintain HIPAA compliance and protect patient confidentiality.
Respect patients' cultural and religious beliefs.
Maintain reliable attendance and punctuality.
Must be willing to receive all required vaccinations (i.e., flu shot, etc.).
All new employees working must be fully vaccinated as a condition of employment (unless the new hire has requested and received an exemption).
Candidates for employment will be notified of this policy requirement prior to the start of employment.
After receiving an offer of employment, new employees must provide proof of vaccination or request and receive an exemption before beginning work.
To apply, please fill out an application, attach a cover letter, and resume.
Include gaps in employment and reasons for separation.
Criminal background check and pre-employment drug screen required upon conditional job offer.