Director Commercial Insurance Collections

Are you looking for a rewarding career with top-notch benefits? We are looking for a qualified candidates like you to join our Texas Health family.

Job Summary

The CBO Revenue Cycle Directors are responsible for management and oversight of all CBO operations. Including, but not limited to, strategic planning, coordination and execution of projects, and internal and external relationships.

• Work location: Primarily a work from home position, but the candidate needs to be prepared to work in the Arlington office one day each week. (when asked).

Job Duties

AR Management- Responsible for monitoring all THR hospital entities Patient Accounts Receivables for their specific area, ensuring maximum cash flow and reimbursement for healthcare financing, while striving for the highest satisfaction of patient's service expectation for the System Business Operations Departments.

Culture / Teamwork / Vendor Relationships- Responsible for overseeing the functions of Central Business Operations and assisting the Sr. Director and Vice President of Business Operations in developing and implementing the structure, culture of the department, completion and implementation of the System's Strategic initiatives for Business Operations.

Area Specific Functions:

Quality / Credits-Assuring that low cost operations and maximum reimbursement through continuous improvement processes. That appropriate contractual discounting activities are performed to ensure maximum reimbursement for the assigned accounts receivable. This includes improving operations to reduce avoidable denials. This includes, but not limited to, working with direct reports, interaction with hospital admissions, department heads, CFOs, UM personnel and other departments as applicable to improve quality and reduce expense. Working to improve team effectiveness and ensuring a quality assurance program is followed. This section also includes representing THR/SRS on committees and teams when needed. This quality monitoring also includes the management of the standard of care and medically unlikely edits (CCI_MUE). Maintaining an acceptable level of credit balances and working them as soon as possible also falls under this section.

Denials Management/Appeals:
Director holds these managers responsible for ensuring denials and appeals are managed timely and efficiently. Productivity goals are met or exceeded for appeals analysts. Ensures that Insurance Collections/Reimbursement Manager and appeals analyst staff are maintaining quality workflow processes and efficient daily operations, including but not limited to: system table file builds/maintenance; identifies and appeals denials timely; ensures subsequent appeals are completed timely; resolves appealed accounts timely. Director and Insurance Collections/Reimbursement manager works directly with THR and THPR contract managers when there are payor contract related issues.

Patient Financial Experience:
Director holds these managers responsible for ensuring that all customer service and self pay collection activities are managed timely and efficiently. Productivity goals are met or exceeded. Ensures accounts are moving through cycles and either paid or sent to appropriate outsource vendor for additional work. Maintain consistent quality audits for continuous monitoring/coaching/training of staff to provide an excellent patient financial experience for our patients/consumers. Director is also responsible for managing BD vendors and all operations pertaining to these accounts and managing Financial Assistance program and processes.

Additional duties as assigned

Education
H.S. Diploma or equivalent required. Or, Associate's Degree required
Bachelor's Degree preferred

Experience
5 years experience in Revenue Cycle management (with Associate's Degree) required. Or, 7 years experience in Revenue Cycle management (without Associate's Degree) required. Candidate needs to be very familiar with Excel and EPIC reporting tools. Ability to analyze payment issues and implement/follow the corrections through to completion.

Skills
* Ability to read, interpret, explain and resolve payer billing edits and how they relate to coding and billing requirements utilizing UB editor and/or other resources necessary. * Ability to solve practical and high level problems and deal with a variety of concrete variables in all situations  Ability to read and interpret managed care contracts. * Ability to read and interpret orders for radiology. * Ability to read and interpret rules regarding precert/auth/notification from the payer(s). Ability to read and interpret clinical information provided by the physician. * Ability to understand EFT and ERA protocols * Ability to understand regulations regarding collections rules * Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or government regulations. * Ability to write reports, business correspondence and procedure manuals. * Ability to effectively present information and respond to questions from groups of managers, clients, customers and the general public. * Ability to calculate figures and amounts such as discounts, interest, commissions, proportion, percentages, area, circumference and volume. * Ability to apply concepts of basic algebra and geometry. * Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form. * Ability to train/coach staff effectively in order for them to perform their job functions * Expertise in data analysis, data management, facilitation and project management needed. * Proficient in Excel. * Experience in file transfer protocols preferred. * Strong knowledge of clinical application systems, statistics, and advanced computer skills. * Working knowledge of data collection, aggregation, and display techniques. * Advanced interpersonal skills with ability to communicate effectively and concisely both verbally and in writing. * Must be able to organize, prioritize, and demonstrate excellent time management skills. * Must be highly organized and be able to multi-task. * Must be motivated and a self starter who is able to learn things quickly and work independently. * Ability to write reports and business correspondence and procedure manuals. * Ability to define problems collects data, establish facts and draw valid conclusions. * Ability to interpret and extensive variety of technical instruction in mathematical or diagram form and deal with several abstract and concrete variables. * Effective PC Skills


Why Texas Health?

At Texas Health Resources, our mission is “to improve the health of the people in the communities we serve”.

We are one of the largest faith-based, nonprofit health systems in the United States with a team of more than 24,000 employees of wholly owned/operated facilities plus 2,200 employees of consolidated joint ventures in the greater Dallas Fort Worth area. Our career growth and professional development opportunities are top-notch and our benefits are equally outstanding.

Join our award-winning Texas Health family and become a part of a team that is improving the health of our communities daily. You belong here.

Here are a few of our recent awards:

• 2022 FORTUNE Magazine’s “100 Best Companies to Work For®” (8th year in a row)
• A "Top 100 Places to Work" for 2021 by The Dallas Morning News (10th time)
• #1 as 2021 “20 Best Workplaces in Health Care and Biopharma” by Great Place to Work® and Fortune (7th consecutive year, 6th year as #1)
• “America’s Best Employers for Diversity” list by Forbes
• A “100 Best Workplaces for Millennials" by Fortune and Great Place to Work®
• A 2021 LinkedIn Top Companies in Dallas - Fort Worth list. This award recognizes the best workplaces for team members to grow their careers and honors companies that not only attract talent but also invest in the development of their employees.

Explore our Texas Health careers site for info like Benefits, Job Listings by Category, recent Awards we’ve won and more.