Elwyn Job - 31742240 | CareerArc
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Company: Elwyn
Location: Media, PA
Career Level: Mid-Senior Level
Industries: Government, Nonprofit, Education

Description

POSITION SUMMARY: The Manager of Accounts Receivable requires a detailed understanding of billing / collections, contracts, governmental regulations, and overall project management. This individual serves as management liaison between Elwyn and external third-party payors regarding Accounts Receivable (A/R). This reports and works to resolve reimbursement issues, communicating with and educating Elwyn colleagues on clean claim procedures and other related concerns. In conjunction with Revenue Cycle Director, prepares for and conducts all regularly scheduled external/internal payor meetings to discuss obstacles in, claims, payments, and receivables. This individual oversees running of accounts receivable reports, leads and presides over account receivable audits, and partners with the Revenue Cycle Director/Billing Manager to communicate findings and assist with developing work plans.

DUTIES AND RESPONSIBILITIES:

  • Manages all accounts receivable (A/R) functions including insurance rejections, insurance follow up and consumer collections leading to final account resolution
  • Continually reviews methods of collection to improve days in accounts receivables and yet to be established collection ratios; including establishing accounts receivable teams, collection parameters and setting of measurable goals
  • Maintains the collection process including the establishment and prioritization of queues to be reviewed, assignment of accounts to staff, reviewing of account receivable and denial reports and pertinent operating statistics
  • Leads monthly reviews of standard reports such as, but not limited to, collection reports, aged accounts receivable reports, unpaid claims reports, credit reports and issues collated by Follow-up and Denial staff, as part of monthly collection efforts. Supports finance business partners in monthly A/R review meetings
  • Establishes new policies and procedures and performs on-going reviews of current collection, follow-up and denial procedures to comply with third party regulations and the Fair Debt and Collections Act and other laws regarding the collection of monies from clients/patients
  • Assists in revenue cycle specific projects, including but not limited to A/R cleanup in Profiler (develop approach and recommendations)
  • Maintains tracking log of all collections and denial issues
  • Performs root cause analyses on issues identified and creates action plans; oversees implementation and monitor plan for successful incorporation into routine operations
  • Oversees the implementation of corrective action plans via work in conjunction with Director of to track and resolve all known issues
  • Maintains expertise in all third-party reimbursement procedures, understands regulations, and reads all newsletters and updates with two working days of receipt. Communicate updates to the appropriate Finance Business Partner and Revenue Cycle Director in a timely manner and ensures process changes are implemented as needed
  • Ensures all contract terms are properly loaded in Profiler and where appropriate, expected payments are contractualized at time of bill, and supplies information to Finance Business Partners to assist with contractual allowance and bad debt methodology
  • In conjunction with Revenue Cycle Director, provides supervision of assigned staff in the areas including, but not limited to, recruitment, selection, leadership, coaching, training, performance management, promotion, discipline and termination
  • Trains and holds meetings with staff in order to keep them abreast of current procedures and regulatory changes
  • Directs supervision of the accounts receivable follow-up, denial management and cash posting staff and ensure maximum productivity and value is derived from these roles through accountability and follow through on assignments
  • Resolves of all issues with program staff, clients/patients, outside collection agencies and other customers relating to collection function. Maintains confidentiality of all materials handled within Elwyn as well as the proper release of information.
  • Demonstrates financial responsibility and accountability through the effective and efficient use of resources in daily procedures, processes and practices
  • Evaluates, selects and maintains relations with outside collections agencies
  • Ensures completion of accurate daily application of patient & non-patient cash received through CCP/Profiler and State based billing applications
  • Performs other duties as assigned

IMMEDIATE SUPERVISOR: Revenue Cycle Director

DIRECT REPORTS: Follow-up, Denial Management, and Cash Posting positions

CONTACTS: Elwyn personnel, community, federal, state agencies including Regional Centers and Department of Developmental Services, assigned service coordinator, vendors

EDUCATION/EXPERIENCE/SKILLS REQUIREMENTS:

  • Associate degree in healthcare or related field or directly equivalent combination of directly relevant experience in quality assurance, utilization review, billing, or related area and education may be substituted; bachelor's degree in healthcare or related field preferred
  • Three (3) years of supervisory experience
  • Two (2) years' experience in medical billing
  • Working knowledge of Current Procedural Terminology, 4th Edition (CPT-4), Healthcare Common Procedure Coding System (HCPCS), revenue codes and International Classification of Diseases, Tenth Revision (ICD-10) coding
  • Detailed working knowledge of CCP/Profiler which includes but not limited to billing, payor rule generation and maintenance, accounts receivable work list reporting as well as accounts receivable aging reporting and cash applications
  • Knowledge and experience in Community-based Residential Program and Behavioral Health settings preferred
  • Demonstrated excellent analytical and problem-solving skills, and judgment with specific application to medical and financial data
  • Previous experience in state and government contracts preferred
  • Non-profit human service experience highly preferred
  • Demonstrated ability to work effectively as part of a team
  • Ability to work in a fast-paced environment and manage and prioritize multiple, often competing, priorities
  • Demonstrated strong attention to detail
  • Demonstrated strong time management and organizational skills
  • Demonstrated excellent judgment with the ability to independently solve problems and make decisions or recommendation for change with minimal direct supervision
  • Demonstrated ability to anticipate future needed changes or identify problem areas and make recommendations for change
  • Experience using/knowledge of Electronic Health Record (EHR) / Electronic Medical Record (EMR) preferred
  • Demonstrated intermediate working knowledge with Microsoft Office applications, including Word, Excel, and Outlook
  • Experience with billing applications, CCP / Profiler preferred
  • Must possess excellent customer interaction, collaboration, presentation, and written and verbal communication skills
  • Demonstrated ability to envision, develop, and structure analytical approaches

PHYSICAL DEMANDS/ENVIRONMENTAL PROFILE: See Physical Demands Checklist below which represents the general physical demands and environment conditions to which the employee holding this position must meet, in addition to the duties and responsibilities listed above, to successfully perform the essential functions of this job. Elwyn will engage otherwise qualified candidates for this position whose disabilities may require reasonable accommodations to enable an individual to perform the essential functions.

Elwyn reserves the right to revise or change job duties and responsibilities as needed. This job description is not intended to be an all-inclusive statement of duties and responsibilities of the job nor does it constitute a written or implied contract.

Elwyn is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation and identity, gender identity, national origin, citizenship status, genetic information, disability status, military or veteran status, marital or family status, political activities or affiliations, or any other characteristic protected by local, state, and federal law. #ca


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