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Title

Manager - Medical A/R Collections 

Category Billing  
Description

The West Valley’s leading cardiology group is expanding and looking to add valuable and skilled team members to our comprehensive and long-standing Practice.

Cardiac Solutions provides a personalized, team-oriented approach to patient care by promoting wellness through education, innovation, and technology. We offer intensive educational opportunities for patients through our disease management clinics and employ a multidisciplinary approach. All team members play a vital role in providing our patients with tailored care and support services. Our focus helps to prevent the progression of heart disease and minimize hospital admissions for our patients.

  • Competitive wages
  • Uniform/Scrub Allowance
  • Monday – Friday for most positions
  • 7 Company Paid Holidays*
  • Employee Medical coverage option as low as $23.00 per paycheck*
  • Dental & Vision*
  • Supplemental coverage options to include Life/AD&D, Short-Term, Long-Term, Critical Illness, Hospital, Accidental coverages) *
  • 401(k) retirement plan
  • Paid Time Off*
  • Paid Sick Time
  • Employee Assistance & Discount Programs
    *Available to full-time, regular employees

 

Position Summary:

The A/R Collections Manager’s responsibilities include identifying claims, denials, and appeals are efficiently processed, ensuring aging reports are maintained, and managing the collection team members. The incumbent will also assist with insurance payer contracts, contract analysis, and contract reimbursement negotiations.

 

Responsibilities:

  • Monitors unpaid or denied claims to determine necessary actions to assure timely resolution
  • Obtains and submits necessary documentation required for submitted claims resolution
  • Reviews patient bills for accuracy and completeness of insurance payment and contractual adjustments
  • Anticipates potential billing/reimbursement problems and takes measures to prevent them
  • Efficiently manage patient complaints and answers billing related questions from patients and insurance companies in respect to collections
  • Monitors unbilled accounts and/or uncoded encounters to reduce any billing delays
  • Supervising the A/R team in various duties, such as account management, communications with insurance providers, collections, contract analysis.
  • Working in partnership with the Director to manage team member performance by providing regular feedback, performance reviews, and one-on-one meetings.
  • Participate in overseeing the hiring and training of collection team members.
  • Ensures compliance with relevant federal, state, and payor-specific billing requirements.
  • Regularly provides leadership team with collection status reports.
  • Under the direction of the department Director work in identifying any payer relation issues or contracts that need to be renegotiated or negotiated for the first time.
  • Requires strong communication and interpersonal relationship development with payers both for initial enrollment and for managing changes brought about by payer’s requirements.
  • Knowledge of payer policies, regulations, requirements, and necessary forms
  • Must be able to assist Director in identifying and developing workflow processes to meet the ever-changing regulatory requirements.
  • Works with credentialing department on requests and organize supporting documentation to accompany various provider enrollment applications
  • Demonstrate outstanding attention to detail skills to facilitate obtaining the appropriate signatures and verify application accuracy before submission.
  • Manage relationships and communications with payers for initial enrollment and manage changes brought about by regulatory requirements.
  • Possess in-depth knowledge of payer policies, regulations, requirements, and necessary forms
  • Navigate payer systems to understand specific process requirements and utilize the specific online tools for managing the status of enrollments, electronic claims status, remittances, payments, and clearinghouse activities.
  • Perform other duties as assigned.
 
Position Requirements

QUALIFICATIONS/EXPERIENCE

  • High school diploma or GED equivalent required.
  • Bachelor’s degree in Finance, Business Administration, Healthcare Administration, or related field preferred.
  • Knowledge of CPT codes
  • 3+ years of medical industry collection experience required; previous cardiology experience desired.
  • Previous provider enrollment experience required.
  • Exposure/familiarity with credentialing processes helpful
  • Ability to analyze data and make data-driven decisions.
  • Strong problem-solving and critical thinking skills
  • Knowledge of the Microsoft Suite program
  • Microsoft Word, Excel & PowerPoint advanced knowledge
  • Strong interpersonal and organizational skills.
  • Excellent customer service skills.
  • The ability to work in a fast-paced environment.

 

Required Skills, Knowledge, and Abilities

  • Skilled in prioritizing and processing a high volume of work.
  • Maintain the highest level of confidentiality in accordance with HIPAA guidelines
  • Demonstrate responsiveness and have a sense of urgency when dealing with payers and Providers.
  • Possess the ability to initiate and follow through on detailed regulatory requirements to meet the completion of the application promptly.
  • Knowledge of regulatory requirements related to patient accounting, including a solid understanding of Medicare, Medicaid Commercial and managed care processes.
  • Ability to work and communicate effectively with a diverse group of people including other department managers, team members, physicians, and patients.
  • Ability to read, analyze and interpret financial reports, contracts, and other legal documents helpful.
  • Outstanding ability to work independently to achieve results.
  • Ability to set and maintain priorities when dealing with multiple demands and interruptions.
  • Strong analytical and problem-solving skills.
  • Dedication to the development of others and willingness to coach and mentor people as necessary to promote their personal and professional growth.
 
Full-Time/Part-Time Full-Time  
Shift -not applicable-  
Minimum Education  
Travel Requirements  
Exempt/Non-Exempt Non-Exempt  
Location Peoria Office  
About the Organization Cardiac Solutions is a medical, physician-owned business that provides a comprehensive range of cardiac health services to the general public and referred patients. Founded in 1984 by Dr. Joseph Caplan, our clinics have established a solid reputation for innovative cardiology treatments and personalized cardiovascular care. We are proud of our status as the West Valley's leading cardiology team, specializing in YOUR total heart care. Our board-certified cardiologists always put your treatment and care first, allowing you to have the peace of mind knowing that your heart is in good hands.

With our intensive educational opportunities through nurse-directed clinics, we help prevent the progression of heart disease by offering extensive cardiology testing. Our main goal is to avoid hospital admissions by accurately diagnosing and treating cardiac problems at the earliest possible stage. During this process, you not only build a relationship with your physician, but with the many members of our TEAM, all of whom are focused on YOUR heart health.  
EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.  

This position is currently not accepting applications.

To search for an open position, please go to http://JOSEPHACAPLANMDPCdbaCardiacSolutions.appone.com



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