Account Control Officer

Job Description

Overview:
The Income Manager/ACO is responsible for overseeing the accuracy and efficiency of the billing department while ensuring compliance with insurance regulations and policies. This role involves managing a team, setting production and collection targets, monitoring financial performance, and ensuring timely billing and collections for services rendered. The Income Manager/ACO will contribute to company-wide financial goals by ensuring effective billing procedures and collection practices.

Key Responsibilities:

• Team Management:
  Oversee and manage the Insurance Verification Officer, Billing Officer, and EOB Officer to ensure accuracy, efficiency, and compliance with company standards.
• Regulatory Compliance:
  Stay up-to-date on insurance regulation changes and ensure the team is educated on these updates.
• Monitoring Financial Targets:
  Track weekly production and collections, including billing out the door and estimated collection targets.
• Investigate Insurance Trends:
  Analyze and address any downturns or trends with specific insurance carriers.
• Write-Off Reviews:
  Review all write-off requests to ensure all collection efforts have been exhausted before approving.
• Setting Targets:
  Establish weekly production and collection targets to ensure the company’s yearly financial goals are met.
• Over-the-Counter Collections:
  Enforce policies for over-the-counter collections to minimize the need for post-discharge collection procedures.
• Weekly Department Review:
  Analyze weekly statistics from the billing department and provide guidance to junior staff, creating a battle plan for the team each week.
• Aged Accounts Management:
  Monitor the A/R report and work with aged accounts over 45 days old to ensure no more than 15% of total outstanding GI is over 90 days old.
• Litigation & Special Cases:
  Ensure that all litigation cases, workers’ comp cases, and private pay clients understand their legal responsibilities and the company’s collection policy procedures.
• Timely Billing:
  Ensure that all billing, both for insurance companies and patients, is completed promptly and follows a regimented program of letters, emails, and phone calls for collection.
• Reporting:
  Submit monthly reports to the CEO/Owner, highlighting trends and insights to be discussed at the end of each month.
• Collaboration:
  Actively participate in meetings and collaborate with other departments, including the front desk, to maximize over-the-counter collections from all patients.
• End-of-Month Reporting:
  Participate in the end-of-month meeting with the CEO/Owner and MSO Regional Managers (if applicable) to report on billing stats and financial performance.

Key Metrics and Goals:

• Collections Performance:
• Ratio of cash collections to billed amounts.
• Percentage of payroll as a portion of gross income (GI).
• Calls and Billing Efforts:
• Number of collection calls made to patients per week.
• Number of collection calls and correction calls made to insurance carriers.
• Number of claims re-billed and total amount re-billed.
• Amount collected via online payment platforms (website).
• Amount collected from patients via email statements.
• Production Metrics:
• Weekly production billed out.

Technical Requirements

Qualifications and Skills:

• Proven experience in account management, billing, or financial control within a healthcare or insurance-related environment.
• Strong leadership skills with the ability to manage and mentor a team.
• In-depth knowledge of insurance verification, billing, and collection processes.
• Excellent organizational and time-management skills.
• Ability to analyze financial reports and identify trends.
• Strong communication skills to effectively collaborate with internal teams and external clients.
• Attention to detail and a proactive approach to resolving billing issues and minimizing outstanding balances.

Required Experience:

• Previous experience in a billing, collections, or account control role.
• Experience with insurance verification, billing software, and financial tracking tools.
• Understanding of medical billing regulations and insurance policies.
• Experience in setting and achieving financial targets and goals.