Director, Accounts Receivable
2 months ago
Founded in 2007, The Oncology Institute of Hope and Innovation (TOI) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI is dedicated to offering cutting edge, evidence-based cancer care to a population of more than 1.7 million patients including clinical trials, stem cell transplants, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With 100+ employed clinicians and more than 800 teammates in 60+ clinic locations and growing. TOI is changing oncology for the better.
**Location Requirement: Due to scope of responsibilities, qualified applicants must reside in Moutain or Pacific Time Zone.**:
**Job Summary**:
The Director, Accounts Receivable is responsible for overseeing and coordinating all accounts receivable activities with a goal of maximizing reimbursement in a cost-effective manner. The Director will oversee the overall policies, objectives and initiatives for our company's accounts receivable and collections activities. This individual will work with our outsourced vendor to coordinate all accounts receivable work efforts. Ensures compliance with state and federal laws and regulations for managed care, government programs and other third-party payers. Monitors all RCM processes to determine improvement opportunities and encourages team-based results.
**_ Essential Functions:_**
In collaboration with the Senior Vice President and RCM Director, the Director, AR, will coordinate oversight of AR processes in accordance with established internal and third-party payer requirements:
- Provide strategic direction, lead innovations and operational enhancements/standardization by leveraging best practices and technology to create best in class corporate accounts receivable insurance billing operations.
- Demonstrate strong strategic thinking, collaboration, leadership, problem solving and communication skills with all levels of the organization, payors and the RCM Vendor.
- Collaborate with payors and internal stakeholders including the third-party Vendor to build and implement strategies around first pass accurate payment rate and improve overall operational efficiency.
- Develop strong relationships with payors and collaborate with them to resolve any outstanding claims which have been escalated.
- Oversee, monitor and control all activities related to patient and insurance accounts receivable, which includes collections, customer service, and denial management.
- Supervise and coordinate the accounts receivable management function to consistently yield accurate and timely payments on our claims based on regulatory and payor contractual guidelines.
- In conjunction with the SVP RCM, develop KPIs and dashboard reports to monitor and benchmark AR performance. Set internal goals for KPI metrics.
- Develop and implement improvement plans for underperforming KPI benchmarks and internal goals
- Lead RCA & Prevention Strategies to reduce Denial percentage and improve timely and accurate payment
**Team Leadership and Development, in coordination with Human Resources as appropriate**:
- Coordinate the recruitment and orientation of team members
- Mentor, cross-train, and develop skill set among team members, conducts weekly account reviews, team meetings and 1:1s
- Conducts performance reviews, establish and monitor individual goal achievements
- Utilize internal and external systems and/resources for training
- Comply with and educate team members on relevant state and federal regulations (e.g., Department of Managed Care Health & Safety Law)
- Work with leadership teams to enhance overall department processes, performance, and quality results
**Administrative Management**
- Oversee administrative functions related to staff management including timecard approvals, vacation and sick time requests, and employee changes
- Facilitate preparation of scheduled reports to management
- As an exempt position, evening and/or weekend hours may be required to ensure the fulfillment of all duties and responsibilities
- Other duties as may be assigned or modified, or alternate work schedule
**Managerial Responsibilities**
Directly supervises 4 staff who perform patient financial assistance. This position carries out managerial responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training direct reports; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
**Education and Experience**:
- 5+ experience in healthcare industry (Health Plan, IPA/MSO, Provider)
- 5+ years of experience in collection and credit work
- 5+ years of leadership experience in Revenue Cycle Management.
- Claims experienced preferred.
- Experience managing external vendors.
- Bachelor's degree in healthcare management is preferred.
- Billing exp
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