Job Details: Assistant Manager Medical Insurance Collections Date: Feb 03 2023

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General Purpose of Job:

Oversees the daily operations and training of the Research, Insurance Collection and Support departments. Maintains quality assurance, ensuring all clients’ and corporate goal return percentages are met. Manages a staff of approximately 45.

Requirements:
Ideal candidate will have healthcare management background, preferably hospital business office, multi-physician practice, CBO or collection agency insurance department. Medical Insurance Collections experience REQUIRED with preference
of previous leadership role.

• Self motivated with strong communication skills.
• Strong work ethic and an unfailing desire to achieve individual and team goals.
• Firm understanding of aged A/R 365 days+, appeals process, Medicare/Medicaid, Commercial, Auto, Work Comp, Liability, Crime Victims and State and Federal Insurance Programs. [Accounts assigned are HOSPITAL OR PHYSICIAN SERVICES BASED with the majority being inpatient/outpatient hospital visits].
• Functional knowledge of multi- patient accounting systems such as MediTech, McKesson Star, AS400, etc.
• Ability to bill healthcare claims on UB04 and HCFA1500 forms via paper and electronically.
• Understand RAC Audits, underpayments and recoups.
• Understand ICD9, ICD10, DX, HCPCS, CPT codes and DRGs.
• Ability to interpret EOB’s, denials and medical records data.
• Understand copays, deductibles, co-insurance, non covered charges, etc.
• Able to speak to debtors, payers and attorneys to collect for payment and insurance information.

Essential Duties and Responsibilities:

• Ensure all applicable federal and state laws are followed at all times
• Provides the operation’s manager with daily feedback regarding production levels and reviews staff production on a daily basis to ensure that set targets are achieved
• Fully reviews all system reports on a daily basis. Such reports are department and accounting based
• Reports key indicators to corporate office as directed
• Audits accounts for quality and training
• Provide resource feedback and direction to staff to have account adjudicated as quickly as possible
• Constant focus on urgency and immediate resolution on all accounts
• Understanding of legal representation process and ability to train such to staff
• Works with IT Team to ensure that system issues are quickly addressed
• Makes recommendations to continually refine all processes to increase revenue
• Keeps running total of collection projections for the current and coming months
• Recruits staff and oversees training and development
• Ensures that staff is cross trained – research, insurance collectors and insurance support
• Counsels staff as appropriate, handles all branch level personnel issues including reviews and disciplinary actions
• Conduct departmental meetings
• Works with operations manager to ensure good client relationships and provides feedback during conference calls as necessary
• Works as a team player in conjunction with other departments and reports issues to appropriate manager
• Follow all office procedures to maintain integrity of company
• Open/close office ensuring safety of all associates on company property
• Other duties as assigned

Supervisory Responsibilities:
This position has supervisory responsibilities.

Certificates / Registrations & Education:
Completion of the FDCPA and HIPAA Standards exams
High school diploma or general education degree required
Associates or Bachelor’s degree preferred
Must demonstrate proficiency in personal computers, MS Office Word & Excel.

EXPERIENCE:
5 years of leadership experience required and knowledge of the collection industry required, hospital insurance collections and firm grasp of healthcare A/R Cycle. Knowledge of HIPAA, FDCPA & FCRA laws required.

Bottom line requirements we need notes on with candidate submittal:

1. Completion of the FDCPA and HIPAA Standards exams.
2. High school diploma or general education degree required. Associates or Bachelor’s degree preferred.
3. 5+ years of managerial experience required and knowledge of the collection industry required.
4. Knowledge of FDCPA and FCRA laws.