Responsible for the development and implementation of high quality, accurate and compliant billing and revenue capture processes for multiple service lines. Manages and supervises insurance verification/authorization, claims processing, cash posting, and collection activities and frequently communicates with insurance companies. Understands complex revenue cycle, clinical and operational practices and acts with a high degree of autonomy, in addition to evaluating the effectiveness of billing, accounts receivable procedures, recommending revision as indicated, and improves workflow to optimize efficient billing practices.
- Monitors and controls staff performance to include quality, quantity, timeliness and adherence to policies and procedures.
- Provides appropriate instructions, processes, guidance and support.
- Interviews, selects, and trains new staff.
- Prepares schedules, assigns work, controls attendance, maintains time records and authorizes overtime.
- Initiates corrective action as appropriate.
- Initiates or recommends other personnel actions as appropriate, such as promotions, suspensions, and terminations.
- Participates in current process review and development of new and/or revised work processes, policies and procedures pertaining to billing and accounts receivable performance.
- Prepares reports and analyzes billing and accounts receivable performance as required by departmental, organizational and/or regulatory requirements.
- Performs quality audits per organizational policy and shares results with associates to provide necessary education and performance improvement opportunity.
- Oversees communication with various payers to determine and/or validate appropriate billing procedures and ongoing compliance.
- Responsible for ensuring staff competence on billing/accounts receivable processes including education and ongoing competency development.
- Advises Finance Director and Service Line Directors of any problems which may affect billing, reimbursement, cash flow, etc. Partners with operations to resolve any identified problems.
- Maintains a working knowledge of Medicare, Medicaid and other insurance requirements to ensure compliance with regulatory, accreditation and reimbursement requirements. Monitors adherence to regulations related to areas of responsibility.
- Adheres to all divisional, corporate, regulatory, and HIPAA requirements related to the privacy and security of confidential patient information.
- Performs other duties as assigned or when necessary to maintain operation of the department and/or the company.
Requires a minimum of five (5) years’ experience in healthcare, including a minimum of two (2) years’ in Homecare, Hospice and/or health care industry.
- A minimum of two (2) years’ experience in managing revenue cycle, billing and accounts receivable departments preferred. General accounting knowledge to accurately communicate accounts receivable activity with accounting preferred.
- Proficiency in manual and computerized billing procedures required.
- Ability to problem-solve and strong critical thinking skills required.
- Excellent interpersonal, verbal, and written and computer skills are required.
- Must have the ability to work a flexible schedule as needed to meet the supervisory needs of the department.
- May need to lift, carry, bend, stoop or be otherwise physically active in the normal course of job duties. Must meet or exceed core customer service responsibilities, standards and behaviors as outlined in the HFHS’ Customer Service Policy and summarized below:
- Must practice the customer skills as provided through on-going training and in-services.
- Must possess the following personal qualities:
- Be self-directed
- Be flexible and committed to the team concept
- Demonstrate teamwork, initiative and willingness to learn
- Be open to new learning experiences
- Accepts and respects diversity without judgment
- Demonstrates customer service values
- Works in a normal office environment where there is little discomfort due to noise, heat, dust, etc.
- Works on a computer keyboard for extended periods of time.
- May carry, bend, stoop, climb or otherwise be physically active in the course of job duties.
- May drive to and from various offices located in the Detroit Metropolitan area in varied weather and traffic conditions.
- Requires a Bachelors’ Degree or a minimum of 10 years’ work experience in billing or accounts receivable.
You can reach me at 973-552-4069
Health care , Communication, Billing, Account, Homecare, Accountant, Insurance