Insurance Collections Manager, Workers Comp and Aged Accounts

AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion Care. With our diverse culture, and our values around Innovation, Stewardship, and Unity, we are committed to Advancing Quality, and Improving Lives. We are dedicated to doing more for our patients by providing quality products and services that enhance the entire care experience.

The Collections Manager is a full-time position responsible for overseeing the collection staff and making day-to-day decisions for AIS Healthcare’s Targeted Drug Delivery (TDD) services. This position is responsible for directing and coordination of all functions of the collections processes to ensure maximization of cash flow while maintaining open communications across Financial Services. Collection processes for TDD services include contract analysis, reimbursement, denial management, appeals, resolving billing-related issues with insurance companies or other responsible parties for services rendered, and managing credit balances to ensure timely and accurate resolution. The Collections Manager will routinely perform quality reviews, determine training needs, and assist in documentation of policy and procedure.

AIS Healthcare offers great benefits, including health, vision and dental insurance, long term disability insurance, life insurance, a vacation package, and a 401K plan with a generous employer match. Additionally, we offer a 100% work from home model.

EDUCATION AND EXPERIENCE:

• A high school diploma or general education degree (GED) equivalent is required; bachelor’s degree preferred.
• 5-7 years of healthcare industry experience required.
• Home Infusion, Intrathecal Pain Management experience preferred.
• 3-5 years Revenue Cycle Management experience required.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Oversees the operations of the collections department, encompassing contract analysis, accounts receivables, denials, claims monitoring, adjustments, appeals, credit balances, and staff productivity and quality.
• Manages and oversees the resolution of credit balances, including identification, investigation, and appropriate action (e.g., refunds, adjustments, reclassifications) in compliance with payer and regulatory guidelines.
• Serves as the Subject Matter Expert (SME) for all collection and billing processes.
• Maintains contact with other departments to obtain patient or insurance information needed for claims payment.
• Prepares, analyzes, and distributes bi-weekly progress reporting.
• Prepares, analyzes, and distributes monthly and/or quarterly score cards of department.
• Prepares other billing and financial reports as assigned.
• Responsible for understanding all procedures within regulatory mandates.

• Performs quality reviews on current procedures to monitor and improve efficiency of collection and billing operations.

• Ensures that the activities of the collection operations are conducted in a manner that is consistent with overall department protocol, and are following Federal, State, and payer regulation, guidelines, and requirements.

• Participates in the development and implementation of operating policies and procedures.
• Analyzes trends impacting charges and coding and takes appropriate action to realign staff and revise policies and procedures.

• Supervises collection staff, which includes work allocation, training, and being available for staff needs; motivates employees to achieve peak productivity and performance both in an in-office and remote setting.
• Coordinates staff time off in a manner that does not negatively impact necessary daily functions.

• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Maintains a thorough understanding of NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies.
• Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
• Shares knowledge gained with other staff members and works as a team member.
• Interacts with others in a positive, respectful, and considerate manner.
• Completes hiring, scheduling of staff, time, and attendance review.
• Conducts frequent 1:1’s with staff, team meetings, performance management and reviews, including disciplinary action, as necessary.
• Performs other job related duties as assigned.

QUALIFICATION REQUIREMENTS:

• Understanding of all Revenue Cycle Management functions and integration of one another.
• Ability to recognize, evaluate and exercise good judgment in solving complex situations and advising in accordance with laws and regulations.
• Excellent verbal and written communication and relationship building skills with an ability to prioritize, negotiate, and work with a variety of internal and external stakeholders.

• Strong work ethic with personal qualities of integrity and credibility.

• Ability to deal with highly sensitive and confidential material, strong knowledge of HIPAA privacy guidelines and requirements.
• Competence with ICD-9 and ICD-10.
• Knowledge of medical terminology.
• Ability to lead and direct a diverse department in an environment with frequent changes and priorities.
• Ability to communicate effectively and professionally with patients, visitors, physicians, and coworkers.
• Self-directed, detail oriented, conscientious, organized, and able to follow through.
• Ability to supervise and train employees, to include organizing, prioritizing, and scheduling work assignments to meet timelines.
• Ability to deal in an organized manner with problems involving multiple variables within the scope of the position.
• Ability to make independent decisions when circumstances warrant; make prompt and accurate judgments regarding collection operations.
• Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, and the public.
• Tolerant of frequent interruptions and distractions from staff and other internal support teams.
• Proficient in Microsoft Office, including Outlook, Word, and Excel.
• Travel up to 25%.

Steps to Apply:

To apply for this role, you must complete a Culture Index Assessment to be considered. Please note that your application will not be considered if the Assessment is not completed.

Copy and paste the following link into your browser and press enter. Then, select the corresponding position for which you are applying. (Only one assessment per candidate is required.) The assessment is brief, taking less than ten minutes to complete.

portal.cultureindex.com/public/survey/general/0BFB8F0000

AIS HealthCare™ is the leading provider of advanced sterile, patient-specific intrathecal pump medications and in-home intravenous infusion, including immune globulin therapies. These services, combines with your advanced nursing and care coordination solutions, assist physicians and hospitals in delivering a superior level of care for optimal therapeutic outcomes.

We offer a wonderful work culture, looking for an impact player who is positive, earnest, and hardworking.