Job Description

Company Overview

Sovereign Healthcare is a dynamic and progressive ambulatory surgery centers management organization with key health system partnerships in Arizona and California that include; HonorHealth., Cedars Sinai, and St. Joseph’s Hogue Health. Our strong strategic partnerships have afforded us the opportunity to capitalize on explosive growth.

We are looking for a dynamic proven collections leader to oversee our collections department. This position will oversee $50 million in revenue that will grow to $100 million in the next 12 to 18 months.

Position Purpose

This position oversees the collections department and all staff performing insurance collection follow-up, self-pay collections, and credit balance activity. This position is responsible for providing the day to day guidance and task management of the collections team to maximize cash flow for all patient account receivables and providing feedback to enable continuous improvement within the department. Will be responsible for providing root-cause analysis to target payment barriers and trends while implementing action plans to significantly improve current state of Accounts Receivable. Responsible for providing accounts receivable analysis to Revenue Cycle and Senior Leadership teams on a routine basis.

Must have superb management and business process skills to direct the team with respect to patient accounts receivables, customer service and operations. Accountable for service performance, customer satisfaction and financial performance and must have a proven track record of successful outcomes with responding to inquiries or complaints from healthcare providers, and/or patients. Provides effective leadership and direction to all direct reports while managing and fostering a dynamic and progressive work environment characterized by high integrity, productivity, quality and a commitment to excellence and respect. Coordinates staffing needs for the department in collaboration with recruiting and human resources. Facilitates communication for problem resolution and changes occurring in the organization, or with other departments that may impact the Insurance Verification department. Also responsible for communications with supervisors, managers and directors of other departments to discuss cross-departmental issues and identify potential solutions.

Total Education, Vocational Training and Experience:

Minimum of an Associate’s degree required.

Minimum of 5 years of Healthcare collections experience, and a minimum of three years of management experience in a collections management role, preferably in a multi-division healthcare business.

Skills / Requirements

SKILLS AND ABILITIES

 

  1. Excellent project management organization skills.
  2. Excellent staff mentorship and educational skills.
  3. Problem solving & critical thinking skills
  4. Able to meet deadlines and manage multiple priorities
  5. Strong interpersonal, verbal and written communication skills with a strong phone presence
  6. Knowledge of rules and regulations pertaining to collection methods and techniques
  7. Knowledge of procedural and legal aspects of collecting
  8. Knowledge of utilizing various research channels for updated collection guidelines
  9. Skill in evaluating information or situation and making judgments based on facts
  10. Skill in both verbal and written communication
  11. Skill in time management
  12. Skill in operating a computer
  13. Ability to establish and maintain effective working relationships with patients, employees, and the public
  14. Commitment to excellent customer service

Primary Position Responsibilities

  1. Oversees all collections efforts.
  2. Establishes and assigns work lists and tasks to collections team to ensure the team is effectively working all accounts.
  3. Implements collections policies and procedures
  4. Recruits, hires, and trains collections staff.
  5. Follows up on patients complaints related to collections.
  6. Monitors and analyzes trends. Identifies collection performance improvement opportunities with a goal of maximizing effective collections processes.
  7. Knowledge of managed, worker’s compensation, government and state Medicaid claim processing and reimbursement guidelines.
  8. Performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations.
  9. Submit appeals and monitor accounts for proper reimbursement.
  10. Contacts all assigned accounts in the work queue daily and provide sound collection follow-up on outstanding insurance balances.
  11. Establishes and maintains effective communication with other healthcare providers, insurers, and patients/families to secure accurate and pertinent information to maximize reimbursement.
  12. Monitors and tracks contractual, billing, registration, and posting errors and provides continuous feedback to the department supervisor.
  13. Provides detailed documentation on the collection system to explain the action taken or promise made. Obtains current information on all accounts and records information as required.
  14. Verifies applicable contract by reviewing EOB messages, reviewing patient ID card, and verifying member information for all medical plans.
  15. Answers incoming billing phone calls related to services rendered from insurance companies, patients and staff.
  16. Evaluates patient’s financial status and establishes budget payment plans.
  17. Reviews accounts for possible assignment and makes recommendations to the Collections Coordinator, also prepares information for the collection agency.
  18. Uses good interpersonal skills to promote positive, effective interaction with customers/patients and to promote quality service to ensure flow of information to appropriate staff and professionals.
  19. Responsible for achieving and maintaining cash collection goal.
  20. Performs miscellaneous job related duties as requested by Director of Revenue Cycle.
  21. Demonstrate competencies applicable to the job position.