Director of Hospital Accounts Receivable

Summary:

The Director of Hospital Accounts Receivable develops, coordinates, and directs all Hospital Accounts Receivable management activities related to the revenue cycle including Billing, Collections, Customer services, Denial Management and Budget preparation. The Director ensures accurate and timely billing and collection of all Hospital services at UTMB. This position actively establishes policy and procedure both internally within Revenue Cycle as well as throughout the Enterprise to ensure compliance with all Federal and State-mandated billing and cash collection laws.

The Director coordinates the daily activities related to the planning, implementing and maintaining all functions pertinent to the Patient Financial Service areas. Responsible for continued improvement in staff through education, training and positive enforcement of appropriate working practices. Must be able to meet performance goals to include cash, A/R days, production by area, and denial reduction. The Director is responsible for monitoring changes in the healthcare industry, impacting the billing and collection efforts of the Enterprise.

Scope: Institution-wide

Responsibilities:

• Manages Hospital Accounts Receivable and ensuring that all transactions are posted accurately.
• Responsible for the accurate and timely billing of Hospital accounts in compliance with all State and Federal guidelines.
• Responsible for timely and accurate account resolution, including payer appeals for all denials and underpayments.
• Collaborates and communicates with all levels of leadership throughout the Enterprise on denials trends and opportunities for maximizing reimbursement.
• Responsible for the coordination and provision of personnel and capital resources for Hospital Billing team, as part of RCO.
• Provides guidance and instruction in the interpretation of policies, procedures, and regulations.
• Identifies appropriate internal controls for department; provides mechanisms to monitor and enforce compliance.
• Develops, coordinates, and implements Hospital Accounts Receivable management and revenue cycle activities related to UTMB facilities, including vendor activities.
• Monitors changes in Federal Regulations and advises departments on the impact of pending regulation changes. Establishes policy to ensure compliance with all federal regulations and insurance company requirements related to the revenue cycle for UTMB facilities.
• Interacts with multidisciplinary personnel, including Chairmen, Institutional Leadership, Department Directors, etc., to ensure that processes are developed and maintained to maximize Hospital.
• Develops plans for recruitment and retention of direct subordinates and oversees the recruitment and retention of management and operational staff.
• Works closely with contracting to ensure optimal payer contract terms and is responsible for ensuring the appropriate collection of all payments due under the terms and conditions of those contracts.
• Serves as key contact to Revenue Integrity Team for all Hospital billing items related to gross revenue capture and net revenue opportunity.
• Collaborates with Revenue Integrity to identify and initiate improvements/efficiencies to the revenue cycle for Hospital revenue.
• Responsible for monitoring and managing Hospital Accounts Receivable (AR), Discharge Not Final Bill (DNFB), outstanding claims, underpayment, and denials metrics and ensuring these meet organizational and industry standards.
• Performs other duties as assigned. 

Minimum Qualifications:

• Bachelor's degree in business administration or related field plus eight (8) years of relevant hospital revenue cycle experience to include five (5) years of supervisory/leadership experience.

Preferred Qualifications: 

• Master's degree in business administration plus ten (10) years of hospital accounts receivable experience.
• Revenue cycle experience in an academic teaching environment. 
• Proven track record building teams.
• Epic Patient Accounting System experience. 

Knowledge, Skills and Abilities:

• Knowledge of federal and state collection laws, Medicare, Medicaid, and other third-party pay or regulatory requirements.
• Thorough knowledge of Hospital reimbursement and managed care contract issues.
• Knowledge of automated systems that support Hospital billing services.
• General knowledge of medical terminology and trends.
• Knowledge and detailed understanding of all negotiated agreements.
• Strong communication and interpersonal skills with a high degree of professionalism in dealing with staff at all levels of the institution.
• Excellent relationship-builder and communicator and extensive knowledge of health care operations.
• Effective problem-solving skills.
• Ability to develop, prioritize, and accomplish goals.
• Ability to analyze and evaluate data and make appropriate decisions/recommendations.
• Ability to effectively manage different level staff and delegate responsibilities/tasks.
• Demonstrated project management and performance improvement skills.