Manager, Accounts Receivable

SUMMARY:

We are seeking an experienced, focused A/R Manager with at least five (5) years of progressive hospital business office collections experience in a 250+ bed acute care hospital.  Key success factors:

• Direct experience in leading teams of 10+ members to collect insurance A/R, drive cash, and increase productivity.  Primary experience in billing, claims edit resolution, etc. is helpful

• Strong training background and QA background

• Applicants with at least 2+ years of experience with Epic and strong end-user knowledge of WQs and other Epic functionality will be given preference

• Experience with bolt-on automated workflow tools

• Experience with payer rules and regulations

• Intermediate Excel skills preferred

Duties and Responsibilities:

• Manage the day-to-day activities of the staff supervised on site or remotely for a client hospital.

• Focus the team’s efforts and ensure diligent team follow-up are crucial to this position.

• Leadership capabilities such as answering relevant questions, setting goals, allocation of resources, monitoring, trending of AR and staff accountability are essential.

• Hands-on training of staff is a key element of this role. Monitor the status of outstanding patient accounts, identifying and resolving billing errors and claim denials. Conduct weekly team meetings driving revenue cycle performance needs and continued training, maintain and track SOP’s and process improvement processes.

• Conduct thorough reviews of patient accounts to ensure accuracy of billing codes, patient demographics, and insurance information. 

• Implement strategies to improve collection rates and reduce outstanding accounts receivable. Follow up on complex payer trends, communicate with Management the volume and specific issue along with researched payer specific guidelines.

• Generate regular reports on team performance, including key metrics performance, data to identify potential issues and develop solutions to improve efficiency and revenue cycle management working with Management and escalate trends to Management.

• Mentor and monitor team performance against key metrics goals and monthly collection goals, reduced denials, and productivity met 95% or better. 

• Identify areas for improvement and implement action plan to resolve payer and denial challenges. 

• Provides information regarding patient accounts in response to inquiries, safeguarding confidential information in verbal replies and correspondence.

• Overseeing daily billing and collections for all AR financial classes (Medicare, Medicaid, Worker’s Compensation, BCBS, HMOs/PPOs, commercial insurance, self pays, etc.)

• Interprets and follows up on contracts with insurance companies pertaining to rates, discounts and filing instructions. Proper utilization of federal and state credit collection regulations and guidelines

• Properly handles HR related issues including but not limited to new hire orientation, staffing coverage, time off approvals, timecards, counseling/discipline, and evaluations. Monitor staff productivity

• Coordinates agenda(s), presents findings on all scheduled conference calls Demonstrated level of analytical ability required to research/review patient accounts. Prepare and timely submit all Company and client required reports

Knowledge, Skills, and Abilities:

• Ability to read and write to perform calculations, prepare reports with supporting documentation. Being hands-on with day-to-day activities which may include all PFS areas of the revenue cycle. Demonstrates understanding of the entire revenue cycle. Assists with problem solving, inquiries, and customer interaction

• Understands relevant RCM KPIs to analyze and plan strategies to increase cash and reduce AR and AR concepts. An understanding of hospital, clinic, and Business Office Operations. 

• Proficiency in billing software, electronic health records systems, and data analysis tools. Expert level billing and/or collections with Medicare, Medicaid, commercial and/or self-pay. Ability to motivate the team, delegate tasks effectively, and promote collaboration. Excellent verbal and written communication skills to interact with patients, insurance companies, and internal stakeholders.  

Work Experience, Education, and Certifications:

• Minimum five (5) years of general hospital business office billing and collections experience, with at least 2 years of Manager level experience

• A proficient understanding of medical office or medical terminology training. A high level of professionalism displayed by appearance and conduct. Understand critical access hospital business office operations.

• Strong analytical skills to identify and resolve complex billing issues Note: Specific job responsibilities may vary depending on the size and type of healthcare facility, as well as the complexity of their billing operations.

• High school diploma or equivalent; additional training in medical billing or healthcare administration is a plus.

Working Conditions and Physical Requirements:

Manual dexterity to enter data into and retrieve data from computer. Ability to communicate verbally and in writing. Ability to sit for long periods of time. Ability to move moderately heavy objects (e.g., manuals, boxes of supplies, and light equipment).

70-80% travel to client site(s) required.