Job Description

This position manages and oversees the overall policies, objectives, and initiatives of an organization's ASC revenue cycle activities to optimize the patient financial interaction along the care continuum. The ASC Accounts Receivable Manager assists in managing outside vendors, partners with Finance, and IT, oversees Claims Analysis, and implements best practices to maximize Revenue, all with a focus on process, communication, and team effort.

ESSENTIAL DUTIES

• Leads the identification of opportunities to optimize revenue collection through proper coding, encounter/claims submission, denials management, and payment reconciliation across the enterprise.
• Mantains a comprehensive understanding of exisiting contracts and provides assistance with any negotations to maintain and secure financial agreements with payor sources.
• Interview/train/and review departmental staff.
• Leads business process improvement efforts in collaboration with clinical, operational, growth and IT counterparts to develop automated, repeatable processes and systems to optimize revenue collection.
• Reports essential KPI’s to senior leadership to ensure departmental goals are being met.
• Direct oversight of internal and extended department ensuring workflows and processes are being completed accurately and efficiently.
• Independently identifies and pursues revenue improvement opportunities through process improvement and data management.
• Develops and presents ROI-based recommendations to senior leadership, regarding process changes, revenue capture opportunities, staffing changes, or training opportunities that accelerate or maximize revenue collection.

• Participates in the development of coding and billing strategies, evaluating processes related to Revenue Cycle and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific 3 rd Party Payors).
• Collaborate with all operational teams related to contracting and clinical considerations that impact claims submissions and other reimbursement models and implementing changes and upgrades.
• Manages relations with payers and providers to generate high reimbursement rates and a low level of denials. Partners with Accounting/Finance on reporting monthly revenue numbers, analyzing revenue drivers, and collections of Accounts Receivables.
• Maintains professional relationships and collaborates across teams, managing projects, facilitating meetings and presenting in various settings, including senior leadership.
• Prepares and coordinates revenue cycle responsibilities within the acquisition/implementation process. This includes but is not limited to staff onboarding, vendor management, and clearinghouse management.

SKILLS/QUALIFICATIONS/EXPERIENCE

• 4+ years experience in hospital billing and follow up experience processes in a business office/remote setting.
• 3+ years experience in a accounts receivable leadership role.
• Bachelor’s degree in related field preferred but not required.
• Must have high school or equivalent educational experience.
• Demonstrate an understanding of healthcare management, including staffing and leadership.
• Insurance Denial and appeals background.
• Demonstrate an understanding of patient accounts.
• Ability to educate patients on explanation of benefits for insurance processed claims.
• Communicate effectively with healthcare workers, patients and insurance companies.
• Able to prioritize and organize tasks at hand.
• Strong attention to detail, positive attitude and a proven ability to lead a team to success.
• Proficient in Microsoft Word, Outlook and Excel.
• Knowledge of state regulations.

Job Tags

Similar Jobs