Support, oversee, and manage the performance, productivity and quality of the entire Billing, Follow-Up/Denials team as it relates to all AR Management activities and pre-defined and Manager identified goals and targets.
Develop, implement, and manage efficient and effective operational policies, procedures, processes and performance monitoring across all third-party AR resolution, denials management, credit balance resolution and payment variance recoupment.
1. Ensure CCHC employees and vendor staff performing AR functions are compliant with policies, procedures and processes; measure and address all areas of non-compliance.
Maintain up-to-date knowledge of regulatory and compliance, for state and federal agency, changes impacting billing requirements and operations.
1. Collaborate with other disciplines, IT partner and vendors to implement changes needed to address payer and regulatory billing requirement changes and denial prevention.
2. Ensure vendors and CCHC revenue cycle employees are appropriately educated and trained as well as department policies and processes are modified, as required, to stay current.
Work with Managed Care department, payor representative, vendors and all other departments within CCHC and Physician Practices to resolve outstanding account receivable issues
1. Ensure negotiated contracts are being administered and reimbursed according to contractual terms and rates. Assist managed care in the resolution of contract payment issues.
Confirm staff are consistently performing performance-monitoring processes.
Define, implement, and monitor strategies to improve overall patient financial services processing efficiency.
Ensure that denial trends identified are managed and tracked to improvement ensuring mitigation strategies are consistently implemented.
Manage to applicable Key Performance Indicators (“KPIs”). Define and implement action plans when performance is not meeting expectations.
1. Assess workflow prioritization on a regular basis to confirm that AR metrics and benchmarks are consistently achieved.
2. Originate and/or execute a portfolio of performance improvement projects for overall revenue cycle enhancement
3. Conduct analysis as needed and on a timely basis, to support decisions by leadership and maintain/grow revenue collections.
Assess direct reports’ performance on a consistent basis and provide feedback to reward effective performance and enable proactive performance improvement steps to be taken.
Originate and/or execute a portfolio of performance improvement projects for overall revenue cycle enhancement.
Prepares reports and conducts analysis as needed and on a timely basis, to support decisions by leadership and maintain/grow revenue collection.
Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional healthcare related organizations
Uses experience, education, training and judgment to plan and accomplish key performance indicators for AR metrics and other measures of organizational health.
1. Educating, training and setting expectations on using the EHR system efficiently and effectively to meet industry key performance indicators.
2. Maintains up-to-date payer knowledge including regular access to payer websites and portals to ensure the AR is flowing timely and appropriately.
Performs additional special assignments, duties, and related functions as required.
Works with Director of System PFS, Director PB Revenue Cycle, VP, CFO and vendor(s) to establish customer service / SBO revenue cycle benchmarks

Reduce redundancies and re-work through proper use of technology and through staff education.
Serves as the main point of contact for Patient AR Management including Client Submitter, and VNA AR.
Challenges current working practices; identifies process improvement opportunities and presents recommendations and solutions to management. Engages and commits to the organization’s culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence.

Bachelor's degree preferred or equivalent combination of education and 10 years experience.
Minimum ten years health care with at least five years of healthcare Finance or Accounts Receivable Management experience.
Prior experience with customer service and patient billing operations preferred.
Home healthcare and hospice experience required.
Minimum two years supervisory/management experience in healthcare environment required.
Required three to five years of demonstrated experience with electronic health records. Epic experience preferred.
Ability to work under pressure and manage multiple initiatives concurrently; must be able to work independently, set own priorities and meet deadlines.
Experience and knowledge of regulatory requirements, payer requirements and third-party reimbursement.
An understanding of complex corporate relationships, and an ability to influence within such an environment.
Excellent communication, leadership, delegation, and interpersonal skills.
Ability to evaluate personal performance against established goals.
Ability to communicate with and present to a wide variety of CCHC and external users, including senior management and physicians, as well as outside vendors and consultants.
Demonstrated goal-oriented thinking, operational and organizational skills.
Ability to coach and support staff in their efforts to improve overall performance.
Capable of learning reporting systems and other new tools
Exceptional time management skills.

Cape Cod Healthcare is the leading provider of healthcare services for residents and visitors of Cape Cod. With more than 600 physicians, over 5,000 employees and over 250 volunteers, Cape Cod Healthcare is comprised of two acute care hospitals, a Level III trauma center, the Cape’s leading provider of homecare and hospice services (VNA), seven urgent care centers, a primary and specialty care network, a skilled nursing and rehabilitation facility, an assisted living facility, and numerous health services and programs.

We are committed to achieving and maintaining the highest standards in healthcare by partnering with other health and human service providers and continuing to invest in new technologies. By offering services like imaging and radiology, heart and vascular care, surgical services, orthopedics and urgent care, Cape Cod Healthcare provides access to exceptional medical services across the Cape.

For over a century, we have never wavered from our mission: To coordinate and deliver the highest quality, accessible health services, which enhance the health of all Cape Cod residents and visitors.

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