The Senior Director of Operations oversees a team that manages the day-to-day operations in the Billing/Insurance Follow-Up Department. This position is responsible for process management and creating and measuring metrics to ensure consistency, efficiency and compliance with all organizational, statutory, Federal/State and contractual standards. This position will manage & optimize billing systems, including but not limited to establishing and maintaining patient invoicing and statement procedures, account reviews, claim follow ups, edits, write offs, and payment plans.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Monitor, track, and analyze trends to identify strategic business opportunities
• Verify Insurance Follow up process controls and assess their effectiveness in mitigating operational risks

• Partner with business leaders inside and outside the company to identify best practices that can be leveraged to improve operational efficiency and optimize results of collections and recovery efforts
• Lead operation assessment, development and implementation of operation systems and procedures to improve process cycle times and assure timely billing and collection of fees for services rendered
• Ensure Directors and Manager are conducting timely and complete follow up with insurance companies on unpaid or denied claims
• Monitor denial and no-activity trends by the payer and help identify root cause issues, whether it be internal or payer related
• Identify denial trends or change in payments and participate in development and deployment of tactics to reverse denials
• Report payer issues to leadership and assist in the development of strategies and tactics to address and resolve
• Tracking Unit Key Performance Indicators and completing assessment on a monthly, quarterly and annual basis to identify trends and develop tactics to improve revenue cycle metrics
• Oversee a team of Directors and Manager to ensure department’s billing and collection activities for accuracy and productivity, provide feedback to Leaders and staff for continuous improvement of service quality
• Provide guidance in problem resolution through identification and validation of issues, design and recommendation of corrective actions
• Recruit, train, and develop Managers to perform at best-in-class standards and create an environment of achievement and accountability that cultivates success
• Effectively communicate across all levels of management
• Ensures compliance with Company, Medicare, Medicaid and other payer guidelines and performs routine audits as outlined in policy or as necessary
• Continuously evaluate department efficiency, design and implement improvement strategies as needed
• Other duties as assigned

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION AND EXPERIENCE

• Bachelor’s degree, preferably in Business Administration or in a related discipline or 8 years’ experience in a related field
• Minimum of 6 years of experience managing client services staff, customer-facing experience and customer account management is required
• Experience in Revenue Cycle Management with an emphasis on Billing and Insurance Follow-Up is required

KNOWLEDGE, SKILLS AND ABILITIES

• Knowledge of Medicare, Medicaid, and other third-party payor regulations and billing procedures
• Solid ability to troubleshoot, research, analyze, and interpret data and reports
• Strong interpersonal, communication, and presentation skills
• Must have high attention to detail
• Ability to assist and train billers in prioritizing and accomplish their work assignments
• Effective leadership, strong supervisory, organizational and computer skills
• Ability to work under pressure and manage multiple initiatives concurrently
• Knowledge of insurance terminology and processes
• Medium to advanced proficiency in computer skills using MS Office
• Strong business and industry acumen
• Ability to read and understand a variety of financial information presented in different formats from a variety of sources
• Ability to use necessary tools to manipulate data to produce reports
• Must be self-motivated and work independently
• Ability to multi-task in a fast-paced environment