In most cases, a reimbursement manager is in charge of handling medical accounts and obtaining payment from third parties. In many cases, this entails communicating with insurance companies or government agencies that provide medical insurance to a portion of the population. In order to facilitate payments to the provider, a reimbursement manager will be knowledgeable in various aspects of medical records management.
Although many hospitals and other facilities have specific reimbursement management job positions in their hierarchy, the truth is that reimbursements are handled a variety of financial and insurance handling personnel. Some of these employees may be certified in medical coding and records management, while others may not. Others prioritize connecting with insurance company representatives, while others focus on correcting errors on actual medical claims. Most reimbursement managers, on the other hand, use both of these strategies to collect payments on past-due accounts.
The reimbursement manager is usually “fluent” in a variety of medical coding systems. Most reimbursement managers will be familiar with the ICD9 and ICD10 international coding used for diagnosis, for example. The reimbursement manager may also be capable of deciphering CPT or HPCT codes, which are procedural codes for various medical procedures. Both of these codes can help ensure that medical bills are accurate and that insurers or others pay them on time.
Most reimbursement managers work for a larger medical practice. Reimbursement managers may have their own work area or be considered part of a separate department at a provider. In some cases, especially in smaller practices, the entire department may be one person. Reimbursement managers work in a variety of settings to help medical providers stay in business facilitating incoming accounts receivable.
The Health Insurance Portability and Accountability Act, or HIPAA, is one of the most restrictive laws for reimbursement managers. This law protects patient information and ensures that all medical records are handled correctly. Because a reimbursement manager deals with so much HIPAA-protected data, staying in full compliance with the spirit of the law is likely to be difficult. All records must be kept secure at all times, and medical practices frequently struggle to provide their reimbursement managers with all of the necessary safeguards to ensure that HIPAA is always a top priority and that there are no gaps in compliance.
Receipt managers are often a highly valued part of the overall workplace because all medical providers need money to stay in business. The manner in which different medical offices employ these professionals can reveal a lot about a facility’s overall financial health to an observer. Reimbursement managers must be trained and skilled in records handling and assessment, as well as other critical aspects of the job, in order to be effective.