SCOPE / GENERAL PURPOSE OF JOB:
Responsible for managing the daily functions of the AR Department in accordance with RC Billing standards and Reimbursement policy and procedures. Responsible for timely submission of all adjustments; directly supervises accounts receivable to ensure timely, accurate and productive; generates monthly reports and ensures their accuracy; solves problems and improves efficiency within the AR Department operations while ensuring cash goals are obtained, the lowest possible accounts receivable, the lowest possible DSO and ensuring client satisfaction.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Directs the daily operation of the AR Department to ensure accuracy and timeliness of AR resolution for all clients.
- Ensures that daily, weekly, and monthly AR functions are performed and accurate.
- Ensures all AR staff are properly trained, RCB policy and procedures, Misys/Tiger, Allscripts, Practice EDI Insight, Allscripts Pro PM, Remit Data, CCL, Radiation Coding, Etc.
- Demonstrates thorough understanding of and oversees all aspects of monitoring and interpreting insurance reimbursements and implementing procedures that ensure optimum collection in a manner compliant with Federal and State regulations and RC Billing policy and procedures.
- Works in tandem with the management team to perform timely month-end close for all clients.
- Monitors aged accounts receivable for insurance responsible amounts; ensures that the proper processes are followed and ensures that aging accounts are maintained within RC Billing standards.
- Prepares monthly AR work plan per client, disseminates to staff, follows thorough to ensure accurate and timely AR resolution is sought to the plan.
- Prepares monthly financial analysis on accounts receivable, collection percentages, billing statistics, etc. for reporting and discussion with Business Office Manager and Vice President.
- Oversees daily communication between CBO AR team and client practices.
- Communicates with client as necessary, but not less than monthly; physicians, administration and business departments, Schedules monthly conference calls with clients to discuss the prior months financials, issues identified, issues resolved, etc.
- Implements and ensures compliance with RC Billing Reimbursement Policies and Procedures to maximize efficiency. Ensures compliance with appropriate industry regulations and State and Federal regulations.
- As it relates to AR resolution ensures computer master parameters including CPT-4 and ICD-9 code files, fee schedules, insurance, physician, etc. are accurate. Works with the Misys Administrator for updates and file maintenance.
- Assists the budgetary activities of the Billing Office Manager and Vice President.
- Ensures strong communication and working relationship with the CBO Management team.
- Recruits, hires, and supervises AR staff; assists with developing and attaining performance goals and objectives.
- Evaluates AR staff performance and recommends merit increases, promotions, and disciplinary actions.
- Maintains working knowledge of Radiation Oncology billing and coding guidelines.
- Maintains working day to day knowledge of the practice management system/Misys Tiger.
- Maintains working day to day knowledge of the denial management system/Remit Data.
- Maintains working knowledge of applicable laws and regulations as they relate to assigned responsibilities.
- Maintains confidentiality of all information related to patients, medical staff, finances and cost effective health care delivery issues.
- Strives to achieve and maintain company Days Sales Outstanding and Account Receivable aging standards.
- Assists in the development of and primary responsibility for maintaining productivity standards relating to Accounts Receivable resolutions.
- Training of reporting employees of areas as assignment through job focus.
- Additional Duties as Assigned
EDUCATION AND/OR EXPERIENCE:
- High school diploma or equivalent.
- Bachelor’s degree preferred.
- Minimum seven (7) years medical office management experience.
- Knowledge of fiscal management and human resources management practices.
- Knowledge of organization policies and procedures.
- Knowledge of health care administration principals.
- Knowledge of business office procedures
- Previous supervisory experience required.
- Knowledge of insurance agency operating procedures and practices.
- Skill in exercising initiative, judgment, discretion and decision-making to achieve business unit objectives.
- Skill in identifying and resolving problems.
- Ability to communicate effectively regarding fiscal policies.
- Ability to establish and maintain effective working relationships with all employees and clients.
- Knowledge of CPT-4 and ICD-10 coding.
- Knowledge of Allscripts, Misys/Tiger, Allscripts Pro PM, and Practice EDI Insight preferred.
- Ability to communicate effectively orally and in writing.
CERTIFICATIONS / LICENSURES / CREDENTIALS: None
SUPERVISORY RESPONSIBILITIES: Yes
The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position requires full range of body motion including manual and finger dexterity and eye-hand coordination. The position additionally requires standing/sitting for extensive periods of time. Occasional lifting and carrying items weighing up to forty (40) pounds may be required. Requires corrected vision and hearing to normal range.
The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment involving frequent interaction with staff, clients and the general public.