Job Details

Accounts Receivable Manager

A/R Manager-CBO

Position Purpose (Description)
Manages and coordinates activities of the Claims, Insurance Follow Up and Self Pay Collections staff. Implements systems and procedures to insure accurate and timely reimbursement. Monitors day-to-day operations, including task assignments, goal setting, training, staff meetings, staff productivity and compliance issues. Plans and implements processes and procedures to achieve cash collection targets, accounts receivable aging goals while maintaining budgeted staffing levels. Responsible for Human Resource activities, including hiring, performance appraisals, development plans and disciplinary actions. Communicates both within and outside the department to insure coordinated billing and reimbursement efforts. Manages special projects, as needed. Participates in the department's continuous quality improvement process to achieve excellent provider performance.
Accountability & Thinks Strategically:
1. Champions Innovation and Supports Change

2. Promotes Continuous Learning and Employee Development

3. Works to Establish a Shared Vision

4. Shapes Strategy

Demonstrates Job Knowledge:
1. Provides excellent service to all customers, striving to exceed their expectations, to insure continuous quality improvement to BJC Health Systems' customer-focused environment. Ongoing
• Exemplifies excellent customer service towards patients, families, visitors, volunteers, physicians, and co-workers.
• Demonstrates courtesy, compassion and respect.
• Communicates with all customers in a positive and professional manner.
• Contributes to teamwork and harmonious working relationships.

2. Manages claims and document management staff.
• Meets with regional managers, directors and physicians on all claim submission issues.
• Monitors and evaluates clearinghouse rejection reports. Communicates findings to director, regional managers and office managers.
• Creates a plan of action to help correct problems.
• Ensures all EMC claims and document management processes are completed per department guidelines.
• Ensures all claims submitted are received by payor or turned to patient responsibility by using all provided clearinghouse and payor reports.
• Works with clearinghouse and payors to receive acknowledgement reports from those payors not yet providing them.
• Monitors payor updates with regard to electronic secondary claim submission and updates department protocols to include new payors.

3. Identifies System Problems.
• Identifies system problems affecting EMC claims processes and communicates to the EPM application team for correction and works to resolve issues.

4. Claims on hold.
• Monitors and maintains claims on hold list for all practices and communicates information to director.

5. Manages patient collection staff.
• Monitors all outgoing calls for effectiveness and compliance with collection guidelines.
• Verifies accuracy of accounts for agency placement.
• Tracks success rate of internal collection processes.

6. Ensures accounts are placed with outside collection agencies on a routine basis. Ongoing
• Tracks success rate of collection agency.

7. Manages the receivables for the Medical Group.
• Meets with regional managers, directors and physicians on all AR issues.
• Monitors insurance aging and makes corrections in staffing development as needed.
• Works with Provider Service Representatives from contracted managed care plans and assures contractual obligations affecting reimbursement are adhered to.
• Prepares reports in required formats for distribution to various directors, managers and physicians.
• Prepares ad hoc reports as requested by managers and staff throughout BJCMG.
• Tracks reasons for claim rejections/denials.
• Tracks success rate of appeals.
• Communicates changes in billing guidelines to practices as identified by newsletters and denials received.

8. Personnel Management.
• Recruits, hires and trains new staff.
• Supervises Claims, Insurance F/U and Self Pay Collections staff.
• Distributes and assigns work to Claims, Insurance Follow Up and Self Pay Collections Coordinators and staff.
• Conducts employee performance reviews.
• Counsels employees as needed.

9. Management and Staff Support.
• Leads and documents team meetings with specific focus issues related to workloads.
• Writes and updates the policies and procedures related to Claims, Insurance Follow Up and Self Pay Collections processes.
• Develops staff accountability and productivity standards.
• Develops techniques/tools to improve the efficiency and effectiveness of claims submission, insurance reimbursement and collection efforts.
• Monitors reimbursement patterns to assure that contractual fee schedules amounts as received.

Performs other duties as assigned.

Drives Service Excellence:
Builds a Customer Focused Team

Supports Diversity and Teamwork

Manages to Ensure Safety
Gets Business Results:
Demonstrates Financial Expertise Supports Performance Improvement

M/F/D/V EOE

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