Hospital Collections Manager

Description

An employer is looking for a Commercial Collections Manager. This individual will oversee a team of about 18 direct reports (1 support person, 2 billers, and 15 collectors). The Commercial Manager oversees the claim creation, billing, and collection processes within the department. This role is responsible for developing, implementing, and monitoring programs to ensure accurate and timely claim payments. The Manager ensures daily operations align with departmental and hospital guidelines.

Must have:

• 5+ years of recent experience with high-dollar commercial hospital/facilities collections
• 3+ years experience managing a team of 10+ direct reports within commercial collections
• HS Diploma or GED equivalent
• Experience establishing productivity standards emphasizing quality
• Proven leadership capabilities with experience training/coaching staff and building rapport with direct reports
• Proficient with EHR software

Pluses:

• Bachelor’s Degree
• Experience with Cerner
• Experience with taking a fully on-site department to a hybrid or remote setting

Core Competencies

• Policy and Procedure Management: Develop, maintain, and update department policies and procedures; create and maintain training materials.
• Denial Management: Assist in developing and coordinating a Denial Management process to improve outcomes; gather information to correct and prevent future denials; monitor regulations to ensure current practices.
• Education and Training: Educate management and office staff on claim payment processes.
• Problem Resolution: Assist staff in resolving problem accounts.
• Claims Audits: Perform periodic claims audits to ensure accuracy.
• Budget Monitoring: Monitor expenditures to ensure efficient resource use and budget adherence.
• Work Queue Monitoring: Ensure timely processing of claims.
• Claims Follow-Up: Maintain and follow up on claims in medical review or with edit issues.
• Insurance Management: Serve as the point person for self-pay, non-capitated PPO/HMO, and other commercial insurance patient accounts; maintain the insurance master in the Patient Accounting system.
• Client Billing: Oversee the client billing process.
• Allowance Process: Oversee the uninsured/underinsured allowance process.
• External Relations: Attend meetings with outside providers/vendors regarding Revenue Cycle functions and claims processing.
• Staff Management: Ensure selection, training, orientation, and assignment of department staff; develop performance standards; monitor and manage staff; evaluate performance and recommend personnel actions; encourage professional development; maintain job descriptions; resolve staff grievances.
• Personnel Records: Maintain personnel records; approve CTO; prepare work schedules to ensure adequate coverage.
• Conflict Mediation: Mediate staff conflicts and performance problems; promote teamwork.
• Role Modeling: Act as a role model through verbal and behavioral actions.
• Committee Participation: Attend meetings and participate in committees as directed.
• Liaison Duties: Act as a liaison with other hospital departments, physicians, payors, patients, and their families.
• Goal Setting: Participate in Finance Division Hoshin goals by assisting the Director in establishing departmental goals; assist staff in setting and meeting standards.
• KPI Management: Use KPIs to manage and monitor revenue cycle operations, such as cash collections.
• Staff Duties: Perform duties of department staff as needed.
• Documentation: Utilize an effective internal tracking and documentation process for communications with Government entities, including CMS, Fiscal Intermediaries, Carriers, and the OIG.
• Performance Improvement: Participate in hospital performance improvement activities.
• System Utilization: Use the hospital computer system to update, adjust, and process accurate patient accounts.