Management
The healthcare industry is booming, and so is the popularity of healthcare management positions. Healthcare management is the administrative and executive side of a healthcare company that is responsible for overseeing finances, contracts, policies, quality management systems and clinical operations related to healthcare. There are, however, other types of administrative positions in the healthcare field that are not considered healthcare management, but are just as valuable.
Financial Managers
Finance
In the January 2007 issue of "Healthcare Financial Management," Joseph Fifer, a healthcare financial manager, states that there is an increasing need in the healthcare industry for experienced professional financial managers. As the healthcare field grows, so does the need for highly qualified individuals to handle the money. Financial managers in the healthcare field are responsible for overseeing how company dollars are spent, creating financial budgets, allocating funds across the various departments within the company and ensuring that healthcare encounter claims are billed appropriately. These positions are critical to a healthcare company's ability to manage and track profitability. Financial managers tend to have educational backgrounds in finance, such as degrees in accounting or financial analysis.
Claims Examiners
Claims
Claims examiners are assets to the healthcare field and are becoming commonly sought-after administrative positions. Claims examiners are mid-management staff who are charged with the responsibility of reviewing medical claims submitted to the healthcare company, analyzing the claims for accuracy, checking the claims for potential fraudulent documentation, resolving claim disputes and processing the claims so payment can be made to the healthcare professional who provided the service to the recipient or patient. Claims examiners are not always required to be certified medical coders, but some companies prefer that claims examiners have a strong background in medical records, billing, quality management and even finance.
According to the November 12, 2007 issue of "Modern Healthcare," Gregg Blesch discusses the significance of claims examiners in relation to the federally instituted False Claims Act. The False Claims Act, as Blesch describes, serves to protect monies that are specifically allocated for healthcare purposes from being fraudulently claimed or reimbursed. In response, corporations hire claims examiners to help identify fraudulent claims and maintain compliance.
Contract Specialists
Contracts
The healthcare field is driven by the establishment of contracts. As such, contract specialists are administrative positions that are responsible for overseeing compliance of contractual deliverables. Healthcare contracts usually exist between a healthcare company and doctors, hospitals, pharmacies and pharmaceutical companies. These types of contracts spell out information related to payment agreements, reporting requirements, insurance eligibility for patients and reimbursement schedules.
Contract specialists are valuable to healthcare organizations for developing contracts, creating amendments for changes and monitoring the contracts once they are effective. There are many legalities involved with contracting, so backgrounds in business and healthcare law are helpful for these types of positions.
Tags: healthcare field, healthcare company, administrative positions, responsible overseeing, 2007 issue, claims examiners, False Claims
