Health Information Leadership Specialist
5 days ago
This role offers a unique opportunity to lead our Payment Integrity Practice, providing outsourced claims audit and recoveries services.
\Key Responsibilities:\
- Lead a team of Health Information Managers, Clinical coders, and Registered nurses in the Recoveries Service on behalf of clients.\
- Develop key stakeholder relationships internally and externally.\
- Grow and evolve the Recoveries Service in line with company strategy.
Recoveries\
Deliver value to clients by leveraging knowledge and experience to assess alerts in our proprietary system, HIBIS, to identify potential overpayments.
\Manage the qualification and recovery process on behalf of clients, including reviewing surrounding data, liaising with hospital providers, and representing the client in assessing repayment due.
\Support and Promotional Activities\
- Support and assist with facilitation of customer forums and other training or promotional events as required.\
- Provide timely, professional, and supportive responses to client enquiries.\
- Represent the organization at industry events and conferences.\
- Provide timely advice and support to internal and external stakeholders.
Product Development\
Provide insights into hospital or medical billing practices to product teams.
\Suggest new rules or enhancements to existing rules within HIBIS to drive further value for clients and reduce the incidence of false positives.
\Stakeholder Relations\
Manage and maintain strong relationships with clients, hospitals, industry bodies, and other key stakeholders.
\Business Development\
Support the Head of Customer Experience and Partnerships with business development initiatives as required.
\Confidentiality\
Respect the confidentiality of all sensitive information strictly.
\Personal Development\
Maintain currency of knowledge and experience applicable to the role, including ICD-10-AM coding, DRGs, and private hospital funding models.
\Required Skills and Qualifications\
University degree in Health Information Management or equivalent.
\Certificate in clinical coding auditing highly desirable.
\Hold full membership with the Health Information Management Association Australia.
\Desired Skills/Experience\
Coding and casemix experience preferably in a private hospital context.
\Demonstrated understanding of private hospital funding models.
\Clinical coding audit experience.
\Experience working in Private Health Insurance highly desirable.
\Experience handling Private Health Insurance contracts and billing procedures.
\Team management experience.
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