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