Top Heathcare provider needs a strong leader that is overseeing the whole department:
The Managed Care A/R Team Lead is responsible for overseeing the billing and follow-up functions for all Blue Cross and Managed Care Payers for four hospitals. The total combined net patient services revenue for all four hospitals is $903.6M. Oversees all billing process inclusive of EDI billing. Ensures the daily claim edits are corrected timely allowing claims to be billed promptly and without error in a manner consistent with payer requirements inclusive of local, state, and federal laws and regulations. Responsible for the management of personnel and accounts receivable for Blue Cross and Managed Care insurance groups to ensure all claims are paid within prompt pay guidelines and in accordance with individual payer contracts. Participates in payer meetings. Monitors internal controls inclusive of key performance indicators (KPI’s) and productivity standards.
HS?GED required, BA preferred, 5-8 years exp required and 8 years expereince preferred.
Minimum specific knowledge and skills necessary to perform this job
1. Knowledge of Blue Cross and Managed Care billing/payment requirements. 2. Minimum of 5 years Third Party Payer A/R experience.
3. Proficiency in use of MS Office applications, including Excel. 4. Excellent communication skills, both oral and written.
5. Ability to organize, prioritize and manage multiple projects to successful completion. 6. Ability to maintain effective working relationships at all levels within CHE NJ.
7. Effective analytical and problem solving skills. 8. Ability to use initiative and judgment when making decisions.
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