Manager, Professional AR - Commercial

Professional Accounts Receivable Management

Provides leadership, oversight, administrative support and direction in the management of the professional accounts receivable for commercial payers. Oversees the business office operations to ensure effective and efficient accounts receivable management. Accountable for personnel related duties that include interviewing, job performance evaluations, disciplinary actions, payroll reporting, and enforcing required rules and regulations. Manages resources to meet budgetary, productivity, quality and customer service requirements. Manages resources to ensure timely follow up and collection of outstanding professional commercial receivables.

Education: Bachelor's Degree or 15 years of related AR or accounting or finance experience

Experience: Accounts receivable leadership

Responsibilities:

• Manages the day to day operational processes for multiple lines of business to facilitate effective accounts receivable management.
• Maintains ongoing knowledge of all job functions performed in the areas being managed as well as maintains a thorough working knowledge of all of the systems utilized to perform the work in the areas being managed.
• Communicates effectively with internal and external customers.
• Hires, trains, disciplines, supervises, and motivates all employees.
• Maintains appropriate internal controls, written policies and procedures and safeguards over revenue cycle activities.
• Identifies, discusses, plans and implements (with assistance from Information Technology and Systems) the applications, systems or modifications which will enhance the enterprises revenue cycle systems.
• In collaboration with the Director of Financial Services prepares annual budget for department. Monitors, verifies and reconciles department expenditures on a monthly basis.
• Collaborates with the clinical leadership of service areas and hospitals this role is responsible for billing to ensure effective clinical and financial operations.
• Handles quality assurance/compliance matters as required and expected per policy and Code of Conduct.
• Contributes, interprets and analyzes financial data to identify and monitor performance and establish financial benchmarks for the department.
• Facilitates and collaborates on initiatives within the department, in clinical operational areas and enterprise wide.
• Endorses and performs all required tasks associated with the Carle Experience such as, but not limited to, regular rounding with staff and completion of all reports needed to have meaningful and productive monthly meetings.
• Works in conjunction with Finance/Accounting to ensure accurate tracking, capturing and reporting of revenue, payments and adjustments for assigned providers.
• Serves as the Carle Health PB Commercial subject matter expert related to billing, credit balances, denials and reimbursement. Proficient within associated system applications for assigned portfolios, including but not limited to Epic, Meditech, and Mediquant.
• Maintains working knowledge of CPT, ICD, HCPCS code sets as well as HIPAA transaction code sets and payer rules and regulations. Creates, updates, maintains, adheres and enforces all Carle administrative and departmental policy and procedures. All other duties as assigned