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Brett Roberts
Reimbursement Director
Summary
A results-oriented and highly accomplished Reimbursement Director with over 10 years of experience in the healthcare industry. Proven ability to optimize revenue, reduce claim denials, and ensure compliance with reimbursement regulations. Expertise in negotiating favorable reimbursement rates, developing reimbursement policies, and leading teams of reimbursement specialists.
Key achievements include:
- Established and implemented a comprehensive reimbursement policy and procedures, resulting in a 15% reduction in claim denials.
- Developed and executed a strategy to optimize revenue by negotiating favorable reimbursement rates with insurance carriers, increasing revenue by $2 million.
- Led a team of reimbursement specialists, providing training and support to improve claim accuracy and processing efficiency.
- Collaborated with billing and coding teams to ensure compliance with reimbursement regulations, minimizing audits and penalties.
- Developed and maintained relationships with key decisionmakers at insurance carriers, advocating for favorable reimbursement policies.
- Utilized data analytics to identify reimbursement trends and areas for improvement, leading to a 10% increase in reimbursement revenue.
- Implemented a reimbursement auditing program to identify and recover underpaid claims, resulting in a $500,000 increase in revenue.
- Oversaw the implementation of a new reimbursement software system, streamlining processes and improving efficiency by 25%.
Education
Bachelor’s Degree
September 2018
Skills
- Medical Billing
- Revenue Cycle Management
- Claims Processing
- Payer Contract Management
- Appeals and Denials Management
- Coding and Compliance
Work Experience
Reimbursement Director
- Developed and maintained relationships with key decisionmakers at insurance carriers, advocating for favorable reimbursement policies.
- Utilized data analytics to identify reimbursement trends and areas for improvement, leading to a 10% increase in reimbursement revenue.
- Implemented a reimbursement auditing program to identify and recover underpaid claims, resulting in a $500,000 increase in revenue.
- Oversaw the implementation of a new reimbursement software system, streamlining processes and improving efficiency by 25%.
Reimbursement Director
- Established and implemented a comprehensive reimbursement policy and procedures, resulting in a 15% reduction in claim denials.
- Developed and executed a strategy to optimize revenue by negotiating favorable reimbursement rates with insurance carriers, increasing revenue by $2 million.
- Led a team of reimbursement specialists, providing training and support to improve claim accuracy and processing efficiency.
- Collaborated with billing and coding teams to ensure compliance with reimbursement regulations, minimizing audits and penalties.
Accomplishments
- Challenge Streamlined a complex reimbursement process, reducing processing time by 25% while maintaining accuracy.
- Action Implemented a comprehensive reimbursement audit system, resulting in a 12% reduction in improper payments.
- Result Led the development of a new reimbursement policy framework, which enhanced compliance by 20%.
- Challenge Effectively managed a team of reimbursement specialists through a challenging transition period.
- Action Developed and executed a training program, enhancing staff knowledge and improving reimbursement accuracy by 15%.
Awards
- Recognized with the Excellence in Reimbursement Management award for exceptional contributions to the field.
- Received the Outstanding Achievement in Health Insurance Reimbursement award for the implementation of innovative strategies.
- Honored with the Reimbursement Process Optimization Champion award for exemplary efficiency enhancements.
- Recognized as a Top 10 Reimbursement Director by Healthcare Business Monthly for innovative leadership.
Certificates
- Certified Reimbursement Specialist (CRS)
- Certified Coding Associate (CCA)
- Certified Professional Coder (CPC)
- Certified Medical Reimbursement Specialist (CMRS)
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How To Write Resume For Reimbursement Director
- Highlight your achievements: Quantify your accomplishments and provide specific examples of how you have improved reimbursement.
- Demonstrate your knowledge of reimbursement regulations: Show that you are up-to-date on the latest reimbursement rules and regulations.
- Showcase your negotiation skills: Explain how you have successfully negotiated favorable reimbursement rates with insurance carriers.
- Emphasize your leadership skills: Describe your experience leading and managing a team of reimbursement specialists.
- Highlight your communication skills: Reimbursement directors need to be able to communicate effectively with a variety of stakeholders, including insurance carriers, providers, and patients.
Essential Experience Highlights for a Strong Reimbursement Director Resume
- Develop and implement reimbursement policies and procedures.
- Negotiate favorable reimbursement rates with insurance carriers.
- Lead and manage a team of reimbursement specialists.
- Collaborate with billing and coding teams to ensure compliance.
- Develop and maintain relationships with key decision-makers.
- Utilize data analytics to identify reimbursement trends.
- Implement reimbursement auditing programs.
Frequently Asked Questions (FAQ’s) For Reimbursement Director
What is the role of a Reimbursement Director?
Reimbursement Directors are responsible for overseeing all aspects of the reimbursement process for their organization. This includes developing and implementing reimbursement policies, negotiating with insurance carriers, and ensuring that the organization receives the maximum amount of reimbursement possible.
What are the key skills and qualifications for a Reimbursement Director?
Reimbursement Directors typically have a bachelor’s degree in business, finance, or a related field. They also have several years of experience in the healthcare industry, and a strong understanding of reimbursement regulations. Additionally, Reimbursement Directors must have excellent negotiation, communication, and leadership skills.
What are the challenges facing Reimbursement Directors?
Reimbursement Directors face a number of challenges, including the ever-changing healthcare landscape, the increasing complexity of reimbursement regulations, and the need to maximize reimbursement while maintaining compliance. Additionally, Reimbursement Directors must be able to effectively manage a team of reimbursement specialists and negotiate with insurance carriers.
What are the opportunities for Reimbursement Directors?
The demand for Reimbursement Directors is expected to grow in the coming years, as healthcare organizations seek to maximize their reimbursement. Additionally, Reimbursement Directors have the opportunity to advance to leadership positions within their organization, such as Vice President of Finance or Chief Financial Officer.
How can I become a Reimbursement Director?
To become a Reimbursement Director, you will need to have a strong educational background in business or finance, as well as several years of experience in the healthcare industry. You will also need to develop strong negotiation, communication, and leadership skills. Additionally, you will need to be able to stay up-to-date on the latest reimbursement regulations.