POSITION SUMMARY
Responsible for managing the follow-up functions of Managed Care and Commercial payors for all patient accounts, and forworking with designated payors to ensure proper reimbursement. Manages and coordinates team efforts between Departments within the National Insurance Center(NIC)
ESSENTIAL DUTIES AND RESPONSIBILITIE
- Ensures compliance with state and federal laws and regulations for Managed Care and other third party payor
- Maintains a thorough understanding of Managed Care concepts including HMO, PPO, POS, EPO and capitation
- Facilitates the identification of issues and solutions by team members related to delays in achieving payment resolution
- Monitors collection processes to determine cash flow improvement opportunities
- Manages the aging of accounts receivable by trending and analyzing the A/R, and through communication with the payor
- Works with A/R supervisors to identify department training needs for system education, industry updates and changes in collection processes and protocols
- Works with A/R Supervisors and staff to ensure that employee productivity and quality meets standards
- Manages desk assignments to meet employee productivity and collection efforts across all client facilities
KNOWLEDGE, SKILLS, ABILITIES
- Ensures compliance with state and federal laws and regulations for Managed Care and other third-party payors. varies by site
- Maintains a thorough understanding of Managed Care concepts including HMO, PPO, POS, EPO, and capitation. varies by site
- Facilitates the identification of issues and solutions by team members related to delays in achieving payment resolution. varies by site
- Monitors collection processes to determine cash flow improvement opportunities. varies by site
- Manages the aging of accounts receivable by trending and analyzing the A/R, and through communication with the payors. Varies by site
- Works with A/R supervisors to identify department training needs for system education, industry updates, and changes in collection processes and protocols. Varies by site
- Works with A/R Supervisors and staff to ensure that employee productivity and quality meets standards. varies by site
- Manages desk assignments to meet employee productivity and collection efforts across all client facilities.
