Start the day excited to make a difference...end the day knowing you did. Come join our team.
The Insurance Follow-Up Manager manages and oversees all activities of the Insurance Follow-Up and Denials teams for Mary Washington Hospital and Stafford Hospital. This position manages and monitors Associates to ensure compliance with all policies and procedures for effective, efficient, and timely quality of work.
Essential Functions & Responsibilities:
- Manages and oversees the follow-up of all patient service revenues for Mary Washington Hospital and Stafford Hospital.
- Contributes to development of an operating plan and budget. Responsible for managing departments expenses and labor for areas of responsibility.
- Works with department Director in setting yearly goals.
- Responsible for hiring, developing, coaching, discipline, and performance evaluations.
- Maintains and improves the department workflow and utilization of personnel to maximize individual and group productivity, competence and effectiveness.
- Provides support and coaching to assist in identifying denial trends with a focus on prevention.
- Monitors system dashboards and reporting to identify areas of focus and creates structured plans to address.
- Monitors write-offs and ensures all efforts to obtain reimbursement have been exhausted and proper approvals are obtained.
- Interacts with third party billing vendors to provide guidance and to ensure appropriate actions are taken to secure reimbursement. Communicates third party payer updates to Associates and leadership.
- Leads the bi-weekly denials meeting to identify trending and to collaborate with Revenue Cycle colleagues to address and prevent denials.
- Analyzes trends in A/R and sets goals to meet national benchmark standards.
- Maintains knowledge of government and private payer regulations and contracts.
- Maintains effective communication with insurance companies, managed care contractors, and governmental payers.
- Performs other duties as assigned.
- Bachelor's degree in Business, Finance, or Healthcare Administration required.
- A minimum of three (3) years supervisory/management experience required.
- A minimum of five (5) years Patient Accounting experience in a health system or related field required.
- Proficiency with hospital accounts receivable software required, Epic experience preferred.
- Proficiency with Excel and Microsoft Word required.
- Certified Revenue Cycle Specialist (CRCS) or Certified Revenue Cycle Executive (CRCE) preferred.
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.