Working under the direction of the Insurance Director, the Insurance Manager oversees the day-to-day operations for the billing and collections team. This position is responsible for meeting and exceeding department goals and managing project supervisors, billers and collections staff. This position will maintain client relationships at the servicing level and will monitor compliance with State and Federal laws and guidelines. This role is responsible for providing a productive and motivating working environment. The manager should have experience in Hospital & Physician billing and collections, organizing work groups, coaching employees, monitoring progress, enforcing rules, and ensuring quality compliance. The manager is required to possess strong communication and leaderships skills as well as the ability to resolve workplace issues effectively. The manager will be required to train and support their team members and be highly motivated to help the company fulfill its larger mission. The manager must be technologically strong and capable of maximizing technology to improve workflow. The manager must be people oriented, supportive, and flexible to obtain the most of his/her team. Manager should be results oriented ensuring the success of assigned client partnerships and meeting/exceeding client goals and expectations. The Insurance Manager will perform all job-related duties as assigned.
Key Accountabilities:
Project Governance:
-Able to prioritize tasks and work independently without supervision
-Excellent verbal and written communication skills
-Strong attention to details and accuracy
-Strong analytical and research skills
-Ability to analyze inventory and data to maximize collection potentials and develop leaders to perform the same function.
-Leverage appropriate accounts receivable management analysis
-Versed in all insurance payer types, inclusive of all UB-04 and CMS-1500 claim forms.
-Familiar with hospital and physician insurance processes and practices.
-Experienced in 835, ERA’s, EOB’s, and payer portal accesses for claim resolution.
-Understands denials and appeals processes and educates staff accordingly.
-Discovers revenue enhancement opportunities and implements improvements.
-Collaborate with other Department Managers and Directors
Staff:
-Assure that work assignments and staff schedules are distributed in a manner to support our Healthcare client base
-Determine work procedures changes and expedite those changes for applicable team members.
-Develop specific, time-framed and measurable goals and objectives.
-Oversees supervisors and staff in training and education and ensures team is current on all new processes for internal, governmental, and client related.
-Manages staff in areas of HR including performance reviews, conduct expectations, hiring and firing of staff and addresses any performance, quality of work, and/or other concerns in an effective and timely manner.
-Initiates team development projects and looks for performance outliers to identify and improve performance of team.
-Monitor Productivity
-Build a positive work environment.
Policy & Procedure:
-Ensure all functions are compliant with federal, state, local and client procedures and laws
-Understands current policy terms, laws, and regulations appropriate for claims expedition and resolution.
-Oversees development of processes and procedures to best manage processes, staff, and meet client expectations.
-Understands and maximizes technology to best increase collections and reduce touches.
Client:
-Leads in the development of new client relationships and reports progress to upper management.
-Understands and can manage vendor relationships and client expectations.
Other duties as assigned.
Competencies:
-Advanced knowledge of department and company software, processes, policies, procedures, and expectations
-Ability to identify and solve team challenges
-Must be able to actively listen, teach and mentor subordinates
Success measures
-Department, managed teams and applicable team members consistently meet or exceed goals related to KPIs, budget goals and client success
-Takes initiative to identify and implement changes to team and department challenges
-Ensures staff is properly trained and successful in performing their assignments
-Meets expectations for client relationships and project management
-Develops, implements, and tests effective training techniques to improve staff performance and ensure KPIs are met or exceeded
Qualifications
-Associates degree (A.A or A.S.) from an accredited College or University and 6+ years’ experience, or equivalent combination of education and leadership experience.
-Experience with managing multiple teams (30+ employees)
-3 to 5 years of Healthcare revenue cycle/insurance billing experience, preferably both hospital and physician based
-Medicare, Medicaid, HMO, PPO, Commercial Insurance experience required
-Excellent leadership skills
-Great organizational skills and an eye for detail
-Ability to interview, hire and train employees as needed
-Ability to delegate and distribute tasks to employees
-Advanced knowledge of proper techniques and client interfacing ensuring the overall success of client partnership, assigned team, and department
-Ability to practice a high level of confidentiality
-Takes initiative to identify, assess and implement changes to team and department challenges
-Preferred knowledge of applicable industry regulations
-Advanced knowledge of the functions, operations and mission of the specific department
-Better than average written and spoken communication skills
-Outstanding interpersonal relationship building and employee coaching and development skills
-Excellent computer skills must include knowledge of excel, word, and outlook
Work Environment:
*This is a remote position with some PST hours required*
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Meduit is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, religion, sex, age, national origin, disability, military status, genetic information, sexual orientation, marital status, domestic violence victim status or status as a protected veteran or any other federal, state or local protected class.
