National Account Director of Accounts Receivable Insurance Collections
ScionHealth
Application
Details
Posted: 17-Aug-24
Location: Louisville, Kentucky
Salary: Open
Categories:
Operations
Internal Number: 517992
Description
ScionHealth is recruiting for a National Account Director of Accounts Receivable Insurance Collections to join our team!
Job Summary
The National Account Director or Accounts Receivable Insurance Collections is a member of the revenue cycle leadership team and is responsible for the follow-up and collections of all open AR.This leadership role is central to contacting hospitals and insurance companies to address and remediate denials, securing payments on claims previously considered lost.The Director will be pivotal in harnessing data to establish, manage, and refine performance goals, ensuring these goals align with the company's strategic growth objectives.We are looking for a candidate with a robust management background, capable of driving team performance through effective communication, leadership, and a relentless pursuit of excellence.
Job Responsibilities
Lead ScionHealth's Central Business Office (CBO) AR collections operations, working with all business office partners in the short-term and long-term care facilities with overlapping responsibilities to provide guidance in the physician space.
Perform as an expert for the Business Office on all issues related to AR follow up and collections.
Lead, guide, and manage a team of AR collection professionals to achieve daily, weekly, and monthly billing Key Performance Indicators (KPI's) metrics.
Identify root cause and trends leading to AR aging out and identify how to proactively address timely, resolving the inventory.
Become familiar with payer policies regarding corrected claims, payer portals, appeal levels and timely appeal limits.
Create best practices for resolving patient AR including creating workflows pre- and post-visit to address AR build up quicker.
Implement and monitor quality standards to ensure all team members are provided with the tools to ensure success.
Identify and troubleshoot AR liquidation issues by analyzing denials, open AR and payer feedback.
Develop strategy for denial prevention by using system functionality/billing edits.
Hold self and team members accountable for knowledge of, and full compliance with, performance standards as listed on all team member job descriptions.
Demonstrate strong organizational skills, including attention to all details for the full scope of all aspects of daily team functions.
Address concerns and conflicts with coworkers and team members in a constructive manner.Identify and compliment team members on specific areas in which they are performing well.
Problem solves with team members and remove barriers to help improve work processes.
Cooperate with other departments in pursuing opportunities for improvement.
Assist leadership in the development, implementation and analysis of protocols, standards/work methodology and policies to remain consistent with industry trends and company objectives.
Monitor payor performance and outcomes for efficient account resolution.Engage in researching payer websites/payer policies and other reputable online resources to assist as needed with claim/account resolution.
Recommend strategies to improve outcomes and processes.
Collaborate with leadership on cost saving initiatives.
Qualifications
Experience
A minimum of 5 years' experience of hospital AR collections and follow-up experience, with a minimum of 2 years' experience in a supervisory role required.In addition, knowledge through firsthand experience in billing, collections, denials, payment posting, Patient Accounting systems, clearinghouses/claim submissions and rejections and an overall knowledge of insurance portals, needed.
Knowledge/Skills/Abilities
Strong leadership skills with the ability to motivate a team in a fast-paced evolving environment.
Strong analytical and technical skills.
Ability to complete work independently and prioritize work, this includes working in a team environment.
Possess an understanding of HIPAA as it relates to Personal Health Information (PHI).
Basic knowledge of general accounting principles and standards.
Basic knowledge of ICD-10 and CPT guidelines in accordance with federal and payer guidelines, including use of modifiers, NCCI edits, CMS LCD (Local Coverage Determination) and CMS Articles.
Knowledge of insurance reimbursement practices and overall/general thorough understanding of revenue cycle management (RCM).
Basic understanding of medical terminology and experience in various reimbursement/billing methodologies.
Intermediate skills in Microsoft Office (Word, Excel).
Excellent communication and critical thinking skills, as well as sound judgement.
*Depending on a candidate's qualifications, this role may be filled at a different level.