Description
The Director, Billing and Collections is responsible for all Insurance Collections. Develop and implement process change that results in reduction of cost and an improvement in the net revenue. Provides direct support, education and functional oversight.
Responsibilities:
- Lead staff, clients and/or vendor staff to execute revenue cycle tasks.
- Assists in expediting payment processing and resolving problems with major third party payers. Maintain liaison with major payers.
- Ensures processes are in place to identify, trend and eliminate denials, underpayments and increase cash collections.
- Performs on-going reviews of processes, market trends and payer/regulatory changes to identify areas of process improvement that reduce the dollars and resource investment in accounts receivables, enhances patient satisfaction and keeps the institution from any risk related issues.
- Monitors and communicates the latest regulatory requirements to ensure UPMC facilities are compliant with billing requirements.
- Provides analysis and AR trending to Senior management and insures all metrics are monitored and measured appropriately.
- Designs and implement Quality Assurance program targeting goals, not only accuracy and efficiency, but also high levels of patient and physician satisfaction.
- Consults with Senior management and Chief Financial Officers on all facets of the department, including regulatory, payer changes.
- Provides to the Contracting Department data that is central to contract negotiations and evaluations.
- Provides leadership for Insurance Collections for the revenue cycle for both Medipac and EPIC.
- Monitors department's productivity, quality and outcomes to support overall department goal of lowering cost and improving net revenue.
- Performs on-going analysis to ensure manual processes are minimized and electronic/automated processes are implemented to lead to lower cost and improved net revenue.
- Maintain current industry knowledge and trends, attending educational events and participating in committee work as appropriate.
Qualifications
- BA and 7 years of revenue cycle experience, with a minimum of 2 years in a leadership role - OR -
- 11 years of revenue cycle experience with a minimum of 2 years in a leadership role
Licensure, Certifications, and Clearances:
- Act 31 Child Abuse Reporting
- Act 33 with renewal
- Act 34 with renewal
- Act 73 FBI Clearance
UPMC is an Equal Opportunity Employer/Disability/Veteran
Total Rewards
More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life &emdash; because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.
Our Values
At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.