Director, Billing and Collections Job at Chapters Health System
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Role:
The Director of Billing and Collections provides operational leadership for Billing, Payment Posting, Collections and related Revenue Cycle Systems.
Qualifications:
- Bachelor’s degree in Healthcare Administration, Finance or Business
- Minimum of eight (8) years in healthcare revenue cycle and systems technical experience
- Minimum of five (5) years of management experience
- Knowledge of clinical and billing application interfacing
- Experience in System Administrator functions as related to revenue cycle
- Knowledge in claims processing and Third Party Administrator claims processing
- Demonstrated expertise and knowledge with third party payors to include Medicaid, Medicare and state and federal regulations for both acute and professional billing rules and regulations
- Ability to manage in a fast-paced environment, remaining proactive, detailed oriented, resourceful and efficient, with a high level of professionalism
- Proven successful experience leading, coaching, and mentoring management and subordinates
- Excellent critical thinking and time management skills, self-starter, and the ability to manage staff on-site and remotely
- Excellent communication (written and verbal) and interpersonal skills
- PC proficient (Word, Excel, Access, PowerPoint, Outlook, Project, Visio, etc.) and multi-system applications
Competencies:
- Satisfactorily complete competency requirements for this position.
Responsibilities of all employees:
- Represent the Company professionally at all times through care delivered and/or services provided to all clients.
- Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse.
- Comply with Company policies, procedures and standard practices.
- Observe the Company's health, safety and security practices.
- Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company.
- Use resources in a fiscally responsible manner.
- Promote the Company through participation in community and professional organizations.
- Participate proactively in improving performance at the, departmental and individual levels.
- Improve own professional knowledge and skill level.
- Advance electronic media skills.
- Support Company research and educational activities.
- Share expertise with co-workers both formally and informally.
- Participate in Quality Assessment and Performance Improvement activities as appropriate for the position.
Leadership Success Factors:
- Communication. Express thoughts and ideas clearly. Adapt communication style to fit audience.
- Initiative. Originate action to achieve goals.
- Management Identification. Identify with and accept the problems and responsibilities of management.
- Judgment. Make realistic decisions based on logical assumptions which reflect factual information and consideration of organizational resources.
- Planning, Organizing and Controlling. Establish course of action for self and/or others to accomplish a specific goal; plan proper assignments of personnel and appropriate allocation of resources. Monitors results.
- Leadership. Use appropriate interpersonal styles and methods in guiding others toward task accomplishment.
- Work Standards. Set high goals or standards of performance for self and others. Compel others to perform
- Tolerance for Stress. Maintain stability of performance under pressure and/or opposition.
- Innovativeness. Generates and/or recognizes imaginative, creative solutions in work related situations.
- Delegation. Allocate decision making and other responsibilities effectively and appropriately.
- Staff Development. Develop the skills & competencies of subordinates.
- Organizational Sensitivity. Perceive the impact and the implications of decisions on other components of the organization.
- Ethics. Model highest standards of conduct and ethical behavior, adopting a strong position against fraud and abuse.
- Regulatory Compliance: Educate and monitor staff regarding their own and the organization's responsibilities for regulatory compliance.
Job Responsibilities:
- Ownership of the Back-End Revenue Cycle process, including, but not limited to: billing, payment posting, and collections.
- Defines and maintains up-to-date documentation of back-end revenue cycle policies and procedures, with an emphasis on scalability and alignment with best practices.
- Identifies and implements operational and strategic goals and objectives.
- Oversees Billing, Collections, Payment Posting team, and related roles. Responsible for identifying and implementing solutions that support more efficient and effective work performance.
- Oversees, audits, mentors, and trains team members to ensure work is done in accordance with best practice policies and procedures.
- Ensures compliance with Federal and State collections and credit regulations, laws, and guidelines.
- Develops/maintains up-to-date, effective policies and procedures.
- Continuously/proactively communicates and partners with Front End Revenue Cycle team to minimize denials and ensure efficient collections.
- Acts as a liaison with other departments and internal and external stakeholders, achieving positive results.
- Ensures accuracy and integrity of account balances.
- Proactively partners with Corporate Compliance, Care Connect, IT, Clinical, Finance, and other key stakeholders to ensure efficient revenue cycle operations.
- Works with third party vendors to coordinate key activities related to billing, collections, payments, and related functions.
- Proactively engages payers to resolve issues identified.
- Monitors Back-End Revenue Cycle management key performance indicators; identifies and resolves negative performance trends.
- Proactively plans and implements Revenue Cycle systems in alignment with best practices and scalability.
- Responsible for monitoring, identifying, and working with the vendor to resolve EMR/EHR technical issues that negatively affect Revenue Cycle performance.
- Prioritizes, monitors, and optimizes collections activities.
- Oversees the quality assurance (QA) process ensuring that performance issues are identified and rectified in a timely manner. Engages in continuous process improvement to enhance customer service and Revenue Cycle performance.
- Minimizes bad debts for the Organization; collaborating “upstream,” as needed.
- Ensures that team Key Performance Indicators (KPIs) are met, and quickly identifies variances and implements effective actions plans.
- Monitors revenue and KPIs on a daily/weekly/monthly basis.
- Proactively communicates with VP of Revenue Cycle and Accounting leadership about bad debts and reserves.
- Works closely with the Accounting team to ensure timely, effective resolution of cash discrepancies.
- Performs month-end close duties in accordance with organizational policies and timelines.
- Performs other duties as assigned.
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