Senior Director of Billing/Denial Management Job
|Job Title||Senior Director of Billing/Denial Management|
|Organization||Shared Services Center - Fort Smith|
|Location||Fort Smith, Arkansas|
|Field||Credit & Collection|
ESSENTIAL JOB FUNCTIONS:
· Directs and establishes the training and discipline of Shared Services associates in order to meet performance metrics. This includes the coordination of training guidelines; materials and overall direction of delegated areas of responsibility.
· Establishes, implements, and maintains appropriate internal procedures (Standard Operating) for Shared Services associates to meet monthly corporate KPIs and internal benchmarks. This includes the daily direction of high level management such as Managers and Directors in the direct resolution of AR in both a timely and efficient manner.
· Monitors all statistical reports weekly to resolve trends and determine deficiencies; ensures action plans are developed and maintained for improvement.
a. Maintains bad debt at or below current Community Health Systems (CHS) standard
b. Accomplishes cash collection goal as set forth by CHS
c. Maintains AR days at or below planned days as set forth by CHS
· Ensures front end performance of facilities is aligned with overall goals and active communication with the CFO regarding issues is identified and actions developed for resolution.
a. Achieves front end collection goals through aggressive collection efforts daily
b. Ensures rejection and denial rates related to pre-arrival and registration are minimized
c. Ensures Unbilled and Alert Items are resolved for timely billing
d. Monitors and reviews all Front End Vendor efforts that stagnate AR such as eligibility vendor
- Reviews facility’s monthly adjustments by code to ensure stable trend is present. This includes 986 (denial) adjustment logs to check accuracy of discounts and resolution of account
· Ensures delegation of daily cash report verifying all discounts have been given and researching accounts with large outstanding balances
· Serves as complete revenue cycle liaison with Facility and SSC to ensure that the service level is being met for SSC performance to facility and facility performance is being met for the achievement of the KPI standards. This may include onsite visits for training or gathering of multidiscipline teams in resolving outstanding issues.
· Thorough understanding of third party reimbursement to provide technical support to office
· Reviews monthly internal processes within the SSC to ensure that minimal disruption is occurring for the facility net revenue:
a. Credit balance report (duplicated contractuals)
b. Late Charge report (facility vs. SSC origination)
c. Denials by reason
d. Posting monitors and variances; unidentified
e. Vendor performance (collection agencies, eligibility, etc)
· Provides weekly statistical report to Corporate on AR and Bad Debt.
· Identifies and promotes the negotiation of patterned payer issues and possible settlements on a monthly basis.
· Monitors CHS computer system and recommends changes and enhancements to assist in the processing of patient accounts. This includes the reviews patient files in computer system to ensure all collection activity is thorough, accurately documented and exhaustive in efforts.
- Understands and educates on all proper billing compliance and new payer policies for each year changes; compliant with any regulatory changes
· Participates in all educational activities, and demonstrates personal responsibility for job performance.
· Ability to work with technology necessary to complete job effectively. This includes, but is not limited to phone technology, PULSE/DAR/HMS products, insurance verification / eligibility tools, patient liability estimation tools, and scanning technology.
· Organizes work/resources to accomplish objectives and meet deadlines.
· Maintains stable performance under pressure or opposition. Handles stress in ways to maintain relationships with patients, customers and co-workers.
· Other relevant work functions, as requested.
EDUCATION, SKILLS & EXPERIENCE:
BA/BS Degree or higher in business, accounting or finance preferred
Five years of relative experience in hospital billing, collections or Business Office
Minimum two years supervisory or management experience required
Must be familiar with revenue cycle structure and process
Create reports and/or presentations in Excel, Power Point or Word accurately and efficiently
Coordinate meetings and training sessions
Communicate effectively, timely and professionally
Work collaboratively with corporate, facility leadership and all SSC leadership and associates