Full-Time Reimbursement Supervisor-Patient Accounting

Job Description

Job Description

Salary: Pay commensurate with experience.

At Ashe Memorial Hospital, we are driven by our Mission Statement, "To meet the needs of the community by delivering patient-centered, high quality health care."

Ashe Memorial Hospital is proud to be Voted Ashe's Best Place to Work 2022, 2023, 2024 & 2025. Come be a part of our dynamic team; you'll join Ashe's 2022 & 2023 Best Hospital, Best Surgeon, Best Physician, Best Nurse, and Best Medical Practice! This is your opportunity to make a large difference in a small community!

Hours: Monday through Friday, general business hours. Forty (40) hours per week. Evening and weekend if necessary. This position has supervisory responsibilities.

Job Summary:

The Reimbursement Supervisoris responsible forsupporting the organizations 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 inidentifyingrevenue 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,supervisorand train assigned team members.This role willassistwith analysisforthird-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 ensureaccuratebilling practices, compliant charging workflows, and effective denial mitigation strategies.

MINIMUM JOB QUAILIFICATIONS

Education:

• Associate degree in Healthcare Administration, Business, Finance, Health Information Management, or related fieldrequired.

• Bachelors degree preferred.

experience:

Experience:

• Minimum of 35 years of revenue cycle, billing, coding, denial management, or revenue integrity experience in a healthcare settingrequired.

• Critical Access Hospital or hospital-based experience preferred.

• Experience with CDM maintenance and billing compliance is highly preferred.

License/certifications:

• 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 berequiredto obtain an approved certification withtwelve (12) months of hire.

Primary Job Responsibilities

Revenue Integrity

• 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.

Denials Management

• 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.

Charge Description Master (CDM) Management

• 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.

Collaboration

• 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.

Compliance & Reporting

• 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.

Other Responsibilities

• 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.

***Benefits apply the 1st of the month following employment, per policy.***

*For full job description and benefits, please contact Human Resources.

Ashe Memorial Hospital is an equal opportunity employer and, as such, considers individuals for employment according to their abilities and performance. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care. Employment decisions are made without regard to race, age, religion, color, sex, national origin, physical or mental disability, marital or veteran status, sexual orientation, genetic information, or any other classification protected by law. All employment requirements mandated by local, state, and federal regulations will be observed.