Flybridge Staffing is currently searching for an Associate Director of Insurance Services for a client in the South Florida area. This position will be flex schedule with 3 days in 2 days remote. This role will lead and direct the Insurance Services team to provide comprehensive consultative support and guidance regarding the payer organizations to physicians, physician’s staff, patients, and internal employees. Additionally, the Associate Director will liaise with managed care organizations, insurance companies, governmental payers, physicians, and vendors to ensure consistency.
- Bachelor's degree from four-year college or equivalent experience
- Eight years specific experience in an insurance company or medical practice environment analyzing insurance contracts, and/or billing/claims operations. Must have thorough understanding of Physician office management, billing/coding systems.
- Full understanding of insurance claim processing, revenue cycle management.
- Contract and credentialing management as well as knowledge of malpractice liability insurance requirements.
- Proficient in Microsoft Office applications.
- Provide consultative services to manage all insurance interactions
- Oversee teams to provide insurance specific expertise by analyzing various components of the physician/practice needs and provides appropriate guidance to management.
- Oversee all aspects of implementation processes as it relates to the areas of insurance services. Including identification of insurance companies contracted by physician, payer mix and coordination of all communications relative to the insurance contracts.
- Provide guidance to physicians/staff on re-credentialing and Medicare notification/enrollment during practice changes, ie; new tax ID, relocation, etc.
- Own, monitor, audit, and perform remediation activities specific to insurance data elements for prospect and affiliated physicians throughout their lifecycle and across business processes.
- Direct teams to provide insurance specific recommendations to financial analysts based on prospect insurance data analysis. May represent the team in the ARC meetings and provide information on the insurance analysis.
- Responsible for overseeing presentation of insurance data in physician corporate visit meetings.
- Provide guidance and consultative support to management, coordinators, insurers, physicians, and staff as related to our program and insurance related matters. Review insurance contractual language, including contracts, appeals, and addendums.
- Ensure the review of state level insurance report and makes recommendations to leadership regarding noted trends.
- Oversee communication with insurance companies on behalf of physicians and/or patients when applicable. Responsible for handling insurance company appeals and attending hearings, as requested by the affiliate(s).
- Oversee representation of the department in virtual and onsite corporate visits. Analyze insurance and practice specific information to create and conduct physician training presentations for the physician’s corporate visit.
- Provide guidance to the network regarding coding practices. Responsible for understanding coding changes and communicating such within the network, as needed.
- Oversee the management of the our Malpractice program including the coordination and maintenance of malpractice insurance vendors, as well as the enrollment process for our affiliates.
- CCS (Certified Credentialing Specialist),
- Billing and Coding certifications
- Revenue Cycle Management certification
****NO SPONSORSHIP AVAILABLE**** US Citizen, GC, EAD only please. If your background aligns with the above details and you would like to learn more, please submit your resume to firstname.lastname@example.org or on our website, www.flybridgestaffing.com and one of our recruiters will be in touch with you ASAP.