Description

Position Summary:

The Accounts Receivable Manager oversees processes and controls to ensure the timely and accurate resolution of health insurance claims. This includes ensuring all claims denied by payers are resolved, or if the claim lacks a response, there is targeted follow-up to determine root cause.

Primary Duties & Responsibilities:

Management

• Monthly monitoring of days' sales outstanding for accounts receivable (AR).
• Managing the work allocation amongst the internal AR team on a daily/weekly/monthly basis to ensure all claims are addressed in a timely manner to avoid bad debt and to increase cash collections.
• Collaboration with vendor partner on external AR teamwork allocation.
• Measure AR productivity daily and monitor the accuracy of the work being completed.
• Identify root cause of payer issues resulting in delayed payments.
• Review current processes and workflows , make recommendations for needed changes for more efficient and productive results, and ensure proper division of duties for internal control.
• In collaboration with the vendor partner, create best path resolution steps to resolve unpaid AR
• Creates/Maintains department training manuals and resources.
• Establish relationships with payer representatives to ensure escalated path for claim resolution.
• Identify and manage payer issues. Work directly with payer contacts to escalate targeted AR projects in bulk for favorable resolution.
• Manage month-end close processes to meet established deadlines.
• Enforce guidelines and manage workflows to process bad debt adjustments within the month identified.
• Train new direct reports and continuous employee development; complete performance reviews, hiring, terminating, review of timesheets, and PTO.

Direct Reports

Accounts Receivable Representatives

Qualifications

Qualifications:

• Associate's Degree in Business, Accounting, Finance, or Healthcare Management. Equivalent experience may be substituted for education.
• Minimum of ten (7) years Medical Billing experience.
• Experience as a Billing Manager for a group practice, preferably with centralized billing background.
• Minimum of 5 years of managerial or supervisory experience required.
• Experience with outsourced vendor partner relationships
• Experience in project management with third-party payers, including contractual payment terms, appeals process, and denials.
• Coding or Insurance Specialist Certification desired.

Knowledge, Competencies & Skills:

• Familiarity with surgical specialties, including ASC billing.
• Proficiency in Medical Practice Management Software (IDX, Misys, Allscripts as examples), Excel (Advanced), and other Microsoft applications.
• Superior leadership, problem-solving, team building, and decision-making skills.
• Excellent written, verbal, and interpersonal communication skills.
• Proficient computer software and database skills.
• Strong math and analytical skills.
• Ability to multi-task and work in a fast-paced, high-volume environment.

Physical Requirements for the Job:

• Regularly required to sit 4-7 hours/day and stand 1-3 hours/day.
• Intermittently required to stoop, bend, speak, and listen.