Risk Management Director jobs in Lima, OH

Position Summary: 

Responsible for overseeing the overall policies and objectives of the HCF’s Family of Companies revenue cycle activities, including pricing, billing, third party payer relationships, collections, denials, and reimbursement rates, while monitoring adherence to HCF’s policies/procedures, to optimize cash flow and financial performance.

Essential Functions:

• Because HCF exists to care for our residents, regular attendance and punctuality. are essential to provide quality care and service.
• Leadership: Ability to take action and achieve results through others.
• Commitment to HCF Family of Companies Vision, Values, and Purpose.
• Must be able to complete performance requirements independently while using good judgment as well as have the ability to harmoniously work with others.
• Must be able to take direction and assume responsibility as necessary and initiate appropriate action.
• Must be able to read, write and understand the English language.

Position Responsibilities:

• Follow HCF Policies and Procedures
• Oversee and manage the operations of the billing department.
• Review, design, and maintain policies and procedures regarding pricing, billing, collections, and other financial analysis as needed.
• Ensure all billing operations are conducted in compliance with federal, state, and payer regulations, guidelines, and requirements.
• Plan and direct patient insurance documentation, coding, billing, and data processing to ensure accurate and efficient billing and account collection.
• Analyze billing and claims for accuracy and completeness before submission to Medicare, Medicaid and insurance entities.
• Work in collaboration with Collections Manager, and Denials Team to follow up on outstanding accounts.
• Track and report metrics related to coding error rates, billing turnaround times, and DSO (Days Sales Outstanding)
• Maintain open communication lines with Collections Manager, Regional Directors of Operations, Business Office Managers, and Administrators on significant dollar amount accounts.
• Work in collaboration with the Compliance Department to manage relations with payers and providers to generate high reimbursement rates and low levels of denials.
• Auditing current processes and procedures to monitor and improve efficiency of billing operations.
• Perform other duties as assigned.

Knowledge, Skills and Abilities: 

Must hold a Bachelor’s Degree in Business, Accounting, or a related discipline and/or have previous Revenue Cycle experience in long-term care. A thorough understanding of and experience with Long-term Health Care billing processes and strong organizational, computer, and time management skills are required.