Clinical Director

Nashville, United States | Posted on 10/23/2024

• Industry Nonprofit Charitable Organizations
• Work Experience 1-3 years
• Country United States

Essential Duties and Responsibilities:

• Leverage data-mining and reimbursement modeling tools to review and identify underpayments/denials which are due for additional reimbursement from the payer
• Identify and document underpayment root causes by contacting payers via phone and through review of client systems and account documentation
• 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
• Gain knowledge of general hospital policies and procedures, hospital underpayments, and revenue cycle maximization opportunities
• Ensures productivity and quality standards are met
• Participate in internal client meetings, contributing to a greater understanding of project and initiative progress
• Coaches/Partners with other team members
• Identify and research new placement concept opportunities
• Assist in client reporting
• Strict adherence to HIPAA privacy and security rules, including following MRI policy at all times
• All other duties as assigned

Knowledge, Skills, Abilities:

• Strong analytical, technical, and creative problem-solving skills
• Demonstrated ability to analyze, understand, and communicate complex issues and trends.
• Demonstrated interpersonal skills. Ability to articulate goals clearly and expectations to team members and communicate results to MRI Management.
• Customer-service orientation with the ability to interact with a range of personalities independently and styles to establish effective relationships internally & externally.
• A positive and optimistic attitude that is maintained despite tight deadlines and competing priorities.
• Genuine enthusiasm for working for an evolving start-up with the ability to embrace new ideas.
• Ability to demonstrate high personal ethics consistently, integrity, prudence, energy, initiative, and self-confidence.

Education/

Experience:

• Bachelor’s degree with Healthcare, Business, or relevant background preferred
• Relevant professional experience within the Hospital/Insurance industry preferred
• Expertise within the MS Office Suite including Excel, Word, Outlook, and Access preferred