Description
Standard Qualifications: Parallon believes that organizations that continuously learn and improve will thrive. That's why, after more than a decade, Parallon remains dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry's leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized services in the areas of revenue cycle, purchasing, supply chain, technology, workforce management and consulting. Parallon's purpose is simple. We serve and enable those who care for and improve human life in their communities. JOB TITLE - Director of Denials and Appeals GENERAL SUMMARY OF DUTIES - Directs and coordinates activities of employees engaged in collecting self-pay accounts of customers by performing the following duties personally or through subordinate supervisors. The Accounts Receivable Director is responsible for the self pay team and Manager(s) as direct reports. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performances; rewarding and disciplining employees; addressing complaints and resolving problems. SUPERVISOR - COO SUPERVISES - Directly supervises employees in the Central Business Office. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. DUTIES INCLUDE BUT ARE NOT LIMITED TO: Assures compliance with self-pay and bad debt policies. Establishes and monitors productivity standards, quality improvement and assurance and directs staff in meeting department goals. Completes routine and ad hoc month end closing activities. Assists in compiling reports at month end and as needed. Assists the department manager(s ) in establishing and maintaining policies and procedures. Regularly reviews AR data and develops trends and strategies to improve collectability of all accounts. Reviews in-house collection reports to ascertain status of collections and balances outstanding and to evaluate effectiveness of current collection policies and procedures. Reviews and approves adjustments for Charity, Bankruptcy, Deceased, Small Balance, and Bad Debt. Ensures department is adhering to processes for bankruptcy, deceased, charity, and payment plan processing. Defines and implements workflow in Artiva and eCW as well as any companion software applications Reviews collection agency reports to ascertain status of collections and balances outstanding and to evaluate effectiveness of current collection policies and procedures. Manages automated processes, such as the weekly collection/placement file upload, hospitalists' data lookup, etc. Audits delinquent accounts considered to be uncollectible to ensure maximum efforts have been taken before assigning bad debt status to account. Interacts with any early out and or primary collection agencies and ensures inventory reconciliations are completed and variances explained. Coordinates with Product Support Team on issues related to system performance and operations in technology systems. Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement". KNOWLEDGE, SKILLS & ABILITIES - This position requires the following minimum requirements: QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. LANGUAGE SKILLS Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, and customers. MATHEMATICAL SKILLS Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. REASONING ABILITY Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. EDUCATION - A high school diploma or equivalent is required, an Associate's or Bachelor's degree is highly preferred EXPERIENCE - At least three to five years of medical billing experience along with prior supervisory experience of at least one year. A comprehensive knowledge of CPT & ICD.9 coding is required; CPC is highly preferred. CERTIFICATE/LICENSE - None PHYSICAL DEMANDS/WORKING CONDITIONS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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