3rd Party Insurance Manager

Summary: The Director of Third-Party Insurance is the primary leader responsible for the timely and accurate processing of 3rd party insurance charges and payments, This positions supervises and coordinates activities of workers engaged in calculating, processing, posting, verifying, and maintaining data and payments to accounts receivable records by performing all leadership duties involved in the timely processing of OOMC Insurance Accounts Receivables.

Essential Duties and Responsibilities include the following. Other duties may be assigned as determined by Omni Management.

• Ensure timely and accurate charge capture and billing for all OOMC locations including all surgical and clinic procedures.
• Coordinate with Coding and Compliance to ensure all applicable coding guidelines, policies and best practices are being followed.
• Oversees accounts receivable operations ensuring the timely processing of payments and resolution of aged or aging AR.
• Ensures timely payer credentialing, recredentialing and
• Monitors and manages contractual adjustments and other write-offs.
• Maintain appropriate internal controls for the safeguarding of cash.
• Work closely with the team supervisors and leads to train, schedule, assign, and review work of team members. Develop productivity and quality measures and work with team leadership to implement regular assessments for all team members.
• Actively displays a dedication to the development of others and willingness to coach and mentor people as necessary to promote their personal and professional growth.
• Develop and implement policies and procedures related to insurance billing, payment processing and other accounts receivable activities. Ensure the team has clear and accurate desk references, process documents and other tools that allow for efficient and compliant revenue cycle management processes.
• Monitor, respond to, and communicate changes in billing requirements, regulations, and reimbursement rates, and maintain provider enrollments with payers.
• Build strong work relationships with clinic, central business office and other OOMC leadership to ensure the smooth flow of information between and among OOMC departments.
• Provide support, guidance, training and expectations that develop strong teams, drive positive interactions and support team members career development.
• Identify and resolve problems and inconsistencies and suggests appropriate corrective procedures.
• Communicates and coordinates 3rd party insurance billing and accounts receivable management policies, practices and procedures with department and company managers, officials, clients, customers, and the public as appropriate.
• Regularly provides upper management with revenue cycle status including reports, metrics, and presentations.

Qualifications

Education and/or Experience

Fifth year college or university program certificate; or two to four years related experience and/or training; or equivalent combination of education and experience