Manager, Priority Claims Services

With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions to the broader market. With 160 years of clinical excellence and innovation, Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value. Collectively, Hanger employees touch thousands of lives each day, helping people achieve new levels of mobility and freedom.

The Manager, Priority Claims - Remote is responsible for supporting the company’s claims reimbursement policy efforts and strategic reimbursement plans. Provides administrative leadership in managing and ensuring the uniformity, integrity and timely handling of cases across Hanger Clinic. Provides leadership and guidance to a staff of Specialists and Analysts to ensure accountability and adherence to policies and procedures to facilitate positive outcomes. The position is also responsible for communication of reimbursement information to customers. The position works with the field organization to ensure coverage, coding and reimbursement policies for the company’s products are accurately applied.

This is a remote opportunity. Must be able to work a full daytime shift Monday - Friday. 

Responsibilities will include:

• Lead with recruiting, training and retention of qualified Specialists and Analysts.  Ensure that applicable training materials are comprehensive and complete.  Conduct training of relevant personnel as needed and interface with company training resources.
• Maintain understanding of reimbursement issues and disseminate best practices with other staff members.
• As coding, coverage and reimbursement can change, candidate must be flexible and able to adapt to customer needs, as well as overall reimbursement requirements as determined by the strategic direction within the department.
• Maintain expertise in healthcare policy issues nationally, regionally, and locally.
• Provide ongoing direction to Specialists and Analysts.  Coordinate communications with Directors of Operations, AAM’s and RVP’s. 
• Review and introduce new and existing tools that will effectively improve work processes and outcomes.  Conduct analysis of existing processes and propose process improvements.
• Enforce Compliance with regulatory requirements and Company Policies.  Perform independent audits of responses submitted as well as received.
• Enforce compliance with HIPAA Privacy Rules to ensure the privacy and security of protected health information.
• Perform all employee management actions including hiring and training of new staff, coaching  and development of staff and providing corrective action guidance including full discipline processes for staff.’

Minimum

• Bachelor’s degree in Healthcare Administration, Business Administration or an ancillary medical field and 5 years of experience - OR - an equivalent combination of education/experience
• Experience must include: 
  • Five years’ experience in healthcare reimbursement and/or five years’ experience in patient care center administration required 
  • Five years’ experience in Medicare reimbursement and knowledge of Medicare Policies.
  • Two years supervisory experience.
• Required to be proficient in Windows based office technologies (ex. Word, Excel).

Preferred

• Master’s degree in Healthcare Administration, Business Administration or an ancillary medical field is preferred.
• Eight years’ experience in healthcare reimbursement and/or eight years’ experience in patient care center administration required is preferred.   
• Eight years’ experience in Medicare reimbursement and knowledge of Medicare Policies.
• Five years supervisory experience is preferred.
• Supervising/managing experience in a multi-site environment is preferred. 

The ideal candidate will also demonstrate: 

• Strong interpersonal skills and supervisory skills.

• Strong understanding of financial and accounting practices.

• Able to research, review and comprehend payer policies and reimbursement requirements.

• Competent knowledge of orthotics and/or prosthetics patient care administration.

• Act with integrity in all ways and at all times, remaining honest, transparent, and respectful in all relationships.
• Keep the patient at the center of everything that you do, building lifelong trust.
• Foster open collaboration and constructive dialogue with everyone around you.
• Continuously innovate new solutions, influencing and responding to change.
• Focus on superior outcomes, and calibrate work processes for outstanding results.

Pay range of $82,500 - $103,000 per year + annual bonus: up to 10% of base pay depending on bonus criteria.  This pay range is posted to comply with wage transparency laws.  Hanger salary ranges vary based on skill, ability, knowledge, geographic location and other variables.  

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• Competitive Compensation Packages
• 8 Paid National Holidays & 4 additional Floating Holidays
• PTO that includes Vacation and Sick time
• Medical, Dental, and Vision Benefits
• 401k Savings and Retirement Plan
• Paid Parental Bonding Leave for New Parents
• Flexible Work Schedules and Part-time Opportunities
• Generous Employee Referral Bonus Program
• Mentorship Programs- Mentor and Mentee
• Student Loan Repayment Assistance by Location
• Relocation Assistance
• Regional & National traveling CPO/CO/CP opportunities
• Volunteering for Local and National events such as Hanger’s BAKA Bootcamp and EmpowerFest

Hanger, Inc. is committed to providing equal employment opportunity in all aspects of the employer-employee relationship. All conditions and privileges of employment are administered to all employees without discrimination or harassment because of race, religious creed, color, age, sex, sexual orientation, gender identity, national origin, religion, marital status, medical condition, physical or mental disability, military service, pregnancy, childbirth and related medical conditions, special disabled veteran status, or any other classification protected by federal, state, and local laws and ordinances. The company will comply with all applicable state or local fair employment laws that forbid discrimination or harassment on the basis of other protected characteristics. Retaliation against any employee for filing or supporting a complaint of discrimination or harassment is prohibited.

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