This position is responsible for recruiting, hiring, counseling, training and evaluating employees in the HCFS department. Coordinate budgeting, planning, and administering policies/procedures as appropriate. Assists with identification and improvement of Healthcare Center financial operational processes.
Efficiently and effectively, manage the overall A/R in support of processing in excess of $100,000,000 in annual revenue. Oversee daily operation of the HCFS department bystaffing and directly managing support personnel (Bill/Account Services Associates and Bill/Account Services Senior Associates) including creation of the department and team Annual Performance Objectives (APOs). Monitor results based on the use of the latest Six Sigma statistical measurement and monitoring tools for understanding data variation and process capability. Provide support and assistance within HCFS by planning, organizing, communicating, implementing, and monitoring accounts receivable functions and operations to facilitate the prompt and accurate reconciliation of claims.
Oversee medical practice accounts receivable for eighteen healthcare centers and three Care Today facilities, including improving aging performance, develop policy and procedures, implement “best practice” approach to improve work flow and provide financial management information.
Develop strategies and action plans to maximize revenue or expense reduction opportunity. Influence customers and key decision makers to implement strategies.
Work with the CIGNA Network Managers to identify and resolve claim issues on both an individual and systemic basis.
Monitor claim and financial operations using the latest Six Sigma statistical tools for understanding data variation and process capability.
Work with CIGNA Claims Managers to resolve claim processing and adjudication issues.
Coordinate with CIGNA Network Managers to implement changes in provider payment policies, prior authorization and other related claim and encounter data processing changes.
Provide training and support for Healthcare Centers and Care Today facilities pertaining to all HCFS financial decisions, process flows/changes including North Valley, Paseo, Sun City, Sun City West, and Avondale CareToday centers.
Oversee the efficient utilization of technical and human resources. Develop direct reports.
Develop and maintain departmental standards, policies and procedures.
Develop training programs to assure HCFS staff compliance with departmental requirements.
Establish and monitor HCFS departmental objectives. Establish and monitor key performance indicators and initiate corrective action as necessary. .
Ensure HIPAA compliance and Medicare Regulatory compliance within HCFS.
Effectively communicate training information.
Drive greater employee development and decision making customer focus through the application of quality management practices and team leadership principles.
Handle high level or difficult customer service issues
Prefer 5 years of experience in any of the following areas: medical billing, claims processing, collections, remittance posting, claims analysis, business or financial analysis, compilation of statistics
Bachelor degree or equivalent experience in business management, accounting, or finance with a minimum five years related professional experience in healthcare, formally supervising large groups of employees.
Strong business and finance processes knowledge, analytical, decision making, and problem resolution proficiency. Well versed in billing practices, physician office management, A/R management and automated systems.
Must have at minimum 2-3 years of pervious management experience and problem solving abilities.
Analytical, decision making, problem resolution proficiency and medical billing knowledge.
Excellent oral and written communication skills and proven interpersonal abilities.
Knowledge of HIPAA and Medicare Regulatory compliance.
CIGNA - 17 months ago
With a significant position in the US health insurance market, CIGNA covers some 11.5 million Americans with its various medical plans. The...