ALTUS BIOLOGICS
Full Time Hybrid - Director - Prior Authorization, Patient Assistance & Credenti
ALTUS BIOLOGICS, Pearland, TX, United States
Summary
Our team strives to provide providers with the tools and resources needed to ensure all patients have access to affordable, quality treatment. From patient care, reimbursement and billing reimbursement, we provide excellent patient care across the nation and full service management services to our providers.
Responsibilities
• Oversee operations of the prior authorization, patient assistance and credentialing teams to ensure daily operations are maintained above client and company expectations. Lead a team of leaders, working with individuals to develop them through coaching performance, goal setting and development planning.
• Ensures that the activities of the Prior Authorization, Patient Assistance, and Credentialing departments are conducted in a manner consistent with overall department protocol and are in compliance with federal, state, and payer regulations, guidelines, and requirements. Develop and implement operating policies and procedures.
• Reviews and interprets operational data to implement procedural revisions and enhancements; may oversee the design and implementation of processes to enhance revenue and operating efficiency. Monitor and measure department work processes and implement changes as appropriate.
• Drive high quality patient & client satisfaction while assuring compliance with payors, federal, state and regulatory agencies related to patient access.
• Responsible for completing the annual conflict of interest survey, ensure direct reports complete annual compliance surveys and provide coaching and feedback on performance related to compliance education and ongoing phishing simulation programs.
• Perform other duties as assigned
Minimum Requirements
• Bachelor’s Degree or equivalent experience
• 4 or more years of experience in Practice Management or Revenue Cycle Management
• 3 or more years of leadership experience in the healthcare industry
• 2 or more years of analytical experience in the healthcare industry
• At least basic understanding of Google & Microsoft Suite products
Preferred Requirements
• Masters Degree or equivalent experience
• Certified coder or similar experience
• Practice Management or Revenue Cycle Management experience in the Infusion Industry
• A track record of implementing and accomplishing customer service improvements in a large complex health care organization or system
• A proven track record of results and working with process management
• Ability to analyze and interpret financial reports, government regulations and procedure manuals
• Ability to disseminate information amongst team members to ensure clear interpretation is achieved
• Strong negotiation and persuasion skills
Why work at Altus Biologics?
• Competitive Salary
• Daytime Hours
• Weekends Off
• Paid Time Off
• 9 Company Paid Holidays
• Diverse Workforce
• One-on-One Patient Care
• Corporate & On-The-Job training
• Health Benefits
• Retirement Plan
Altus Biologics provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.This policy applies to all terms and conditions of employment, including recruiting and hiring.
In addition, all employees are expected to adhere to the Altus Biologics' Code of Conduct, Compliance policies and all applicable federal, state, and local laws and regulations. Altus Biologics employees are expected to report any concerns about compliance or business practices to his or her immediate supervisor, appropriate management and/or the Chief Compliance Officer.
#HPIND1
Our team strives to provide providers with the tools and resources needed to ensure all patients have access to affordable, quality treatment. From patient care, reimbursement and billing reimbursement, we provide excellent patient care across the nation and full service management services to our providers.
Responsibilities
• Oversee operations of the prior authorization, patient assistance and credentialing teams to ensure daily operations are maintained above client and company expectations. Lead a team of leaders, working with individuals to develop them through coaching performance, goal setting and development planning.
• Ensures that the activities of the Prior Authorization, Patient Assistance, and Credentialing departments are conducted in a manner consistent with overall department protocol and are in compliance with federal, state, and payer regulations, guidelines, and requirements. Develop and implement operating policies and procedures.
• Reviews and interprets operational data to implement procedural revisions and enhancements; may oversee the design and implementation of processes to enhance revenue and operating efficiency. Monitor and measure department work processes and implement changes as appropriate.
• Drive high quality patient & client satisfaction while assuring compliance with payors, federal, state and regulatory agencies related to patient access.
• Responsible for completing the annual conflict of interest survey, ensure direct reports complete annual compliance surveys and provide coaching and feedback on performance related to compliance education and ongoing phishing simulation programs.
• Perform other duties as assigned
Minimum Requirements
• Bachelor’s Degree or equivalent experience
• 4 or more years of experience in Practice Management or Revenue Cycle Management
• 3 or more years of leadership experience in the healthcare industry
• 2 or more years of analytical experience in the healthcare industry
• At least basic understanding of Google & Microsoft Suite products
Preferred Requirements
• Masters Degree or equivalent experience
• Certified coder or similar experience
• Practice Management or Revenue Cycle Management experience in the Infusion Industry
• A track record of implementing and accomplishing customer service improvements in a large complex health care organization or system
• A proven track record of results and working with process management
• Ability to analyze and interpret financial reports, government regulations and procedure manuals
• Ability to disseminate information amongst team members to ensure clear interpretation is achieved
• Strong negotiation and persuasion skills
Why work at Altus Biologics?
• Competitive Salary
• Daytime Hours
• Weekends Off
• Paid Time Off
• 9 Company Paid Holidays
• Diverse Workforce
• One-on-One Patient Care
• Corporate & On-The-Job training
• Health Benefits
• Retirement Plan
Altus Biologics provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.This policy applies to all terms and conditions of employment, including recruiting and hiring.
In addition, all employees are expected to adhere to the Altus Biologics' Code of Conduct, Compliance policies and all applicable federal, state, and local laws and regulations. Altus Biologics employees are expected to report any concerns about compliance or business practices to his or her immediate supervisor, appropriate management and/or the Chief Compliance Officer.
#HPIND1