- Direct Placement
- Los Angeles, CA
Our client is a leading Physician Practice Management company responsible for the business services for a leading University Children's Medical Group the largest pediatric multi-specialty group in the United States and are acclaimed for their leadership in Pediatric and Adolescent health.
The Account Follow-up Manager is responsible for maximizing the amount of cash collected and minimizing the time period in which it is collected for each assigned payor; for balancing collections across payors; for ensuring that the amounts collected on each invoice are correct; for ensuring that accounts receivable age is maintained within specified levels; for ensuring that the appropriate information can be provided to physicians on the status of their accounts receivable; and for providing feedback to managers on clean claim requirements.
ESSENTIAL DUTIES & RESPONSIBILITIES
- Reviews and analyzes divisional A/R, and monitors payment trends.
- Plans strategy to optimize results for each division/physician.
- Reviews documentation from payors to determine why claims have not been paid; contacts payors accordingly.
- Ensures appropriate follow-up is completed to fix claims, resubmit, write off, etc.
- Identifies issues that require attention (i.e., Front end, Payor & Contracting) and develops plan for addressing.
- Determines status of invoices for collection, denial, suspended, and partial payments.
- Works with Contract Managers to provide support for legislative efforts.
- Monitors success and makes modifications to optimize collections.
- Provides input to update collection model.
- Provides information to physicians and Office Managers.
- Provides functional direction to Account Follow-up Representatives.
- Coordinates workflow and assigns and monitors staffs' work priorities and schedules.
- Reviews assigned work for completeness, accuracy, consistency, and conformity with established guidelines.
- Schedules and oversees assigned tasks to employees.
- Serves as a resource to staff by answering procedural questions and problem solving.
Administrative & Supervisory Functions:
- Performs quality control of work performed by staff.
- Prepares written communication to the Sr Manager on personnel issues, as necessary.
- Administers disciplinary meetings.
- Selects, trains, orients, and supervises departmental staff.
- Evaluates performance and recommends merit increases, promotions, and disciplinary actions to the Sr Manager.
- Works closely with other departmental staff to identify and resolve issues.
- Reviews and approves non-exempt employee timecards.
- Handles in a professional and confidential manner all correspondence, documentation, and files pertaining to billing department.
- Courteous and professional communications with payers and patients.
- Performs follow-up calls or written correspondence to patients, payors and doctors, as needed on a timely basis.
QUALIFICATIONS / REQUIREMENTS
Knowledge of billing regulations at the federal, state, county, city and private payer levels; organizational policies, procedures, systems and objectives. Knowledge of medical records and health care systems (preferably Athena). Skill in planning, organizing, training and supervising. Ability to justify to payor why high dollar charges should be paid; Skill in exercising initiative, judgment, problem-solving and decision-making. Skill in gathering and analyzing data, and researching, preparing & presenting comprehensive reports. Ability to work effectively with staff and management. Ability to use analytical, statistical and critical thinking skills.
- Good written communication skills.
- Good auditory and speaking abilities necessary to communicate effectively.
- Ability to handle multiple tasks simultaneously and meet deadlines.
- Good leadership skills with a team oriented approach.
- Ability to prepare and interpret reports and analysis.
- General interpretation and application, follow-through and attentiveness.
Education and Experience:
- Bachelor's Degree strongly preferred.
- (5) years account follow-up, billing, collection, and supervisory experience.
- Knowledge of CCS, Medi-Cal and Managed Care billing practices preferred.
- Proficiency in MS Word and Excel.
- Ability to work independently.
Commensurate with Experience
Competitive Benefits Package