Direct activities of the Revenue Cycle Management Department including: claims billing, payer accounts receivable, patient collections, denied claims processing, cash posting, and inbound and outbound calls.
- Establishes procedures to ensure maximum efficiency and collection of accounts receivable and ensures adherence to standard operating procedures
- Coordinates the reimbursement activities to include identification of policy issues, review of third party reimbursement changes, Medicare, Medicaid and Commercial requirements and compliance review
- Designs and directs the training process of new employees and ongoing continuous training of staff
- Reports reimbursement trends and global concerns to senior management to ensure corrective actions and mitigation of future occurrences
- Monitors receivables and collections to provide detailed analysis of accounts receivable, day sales outstanding, and collection trends of payers and products
- Establishes standards and goals for verifications, billing, accounts receivable, collections and cash applications to ensure adherence to goals
- Directs and oversees the review of accounts receivable adjustments for accuracy. Monitors the review of refund requests for appropriateness and completion
- Identifies collection problems. Develops and implements procedures to improve activity and profitability
- Interacts with other department directors, managers and supervisors to develop processes to ensure accurate billing and operational functions, and address issues from other departments that affect reimbursement
- Responsible for accuracy and retention of all required records in accordance with applicable laws, regulatory requirements and the Company’s record retention policy. Ensures all reimbursement records are available to support our business practices.
- Oversees performance management initiatives and reengineering efforts such as competency-based assessment, using performance metrics and job function analysis
- Coaches managers and supervisors, with specific and measurable objectives in areas such as people management, leadership, and quality
- Coordinates corporate communications, meetings, and activities while handling dependencies among several remote groups or organizations
- Bachelor’s Degree (BA/BS) from four year college or university and five to seven years combined experience in Medicare, Medicaid and Commercial reimbursement ,collections, A/R management, and insurance verification or the equivalent combination of education and experience.
- A minimum of four years management experience with at least two years responsibility over a large group(s) of employees.
- Familiarity and experience with Electronic Data Interface products (EDI)
- Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists; ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form
- Excellent written and verbal communication skills
CCS Medical - 17 months ago
CCS Medical Holdings knows that doorstep delivery is just a convenience for many, but it's critical for patients with chronic...