Senior Manager, Reimbursement Services (Operations)

POSITION SUMMARY: 

Provides management and support to personnel in Reimbursement Services by having direct responsibility for the assigned portion of the accounts receivable, including the timely and accurate production of bills along with the collection of outstanding invoices and claims. Responsible for the direct supervision of staff within the assigned unit. Additional responsibilities will include maintenance of the accounts receivable and accuracy of all transactions, managing internal and external team members as well as process improvement of the Reimbursement Services team.

PRIMARY RESPONSIBILITIES:

• Demonstrate and communicate the core values of BAYADA and The BAYADA Way.
• Develop working knowledge of BAYADA’s mission, services, people, organization, policies and procedures.
• Supervise multiple teams across several payor types.
• Manage A/R, including bad debt/SRA review for a particular region or business entity.
• Leadership:
  • Manage several teams across several payor types, including internal BAYADA employees and external Vendor teams.
  • Foster a teamwork concept. Instill accountability in team members. Promote trust.
  • Maintain a continuing program for the review and revision of BAYADA’s receivable systems to ensure they are effective and reliable and meet current third-party requirements.
  • Assist with new software installation and recommend modifications as appropriate.
  • Be a change leader who promotes innovation and leads process improvement initiatives.
  • Enthusiastically engage teams with culture exercises.
  • Participate in strategic workforce planning; assess staff and determine future development needs. Ability to communicate such needs/observations with leadership and staff members.
  • Maintain active involvement and understanding of the budgeting process for the assigned team(s).
  • Demonstrate proactive strategic thinking, planning, and execution.
• Operational:
  • Manage and ensure timely production and submittal of invoices/claims and accounts receivable management through effective supervision of Reimbursement Services staff. Responsible for team performance and quality assurance.
  • Responsible for process improvement cross-functionally. Work closely with all Revenue Cycle teams to improve processes that will result in quicker and more efficient reimbursement.
  • Report on quality assurance and internal audit of the assigned portion of the Accounts Receivable to appropriate leadership and escalate concerns accordingly.
  • Oversee and identify trends and new developments with assigned payers and the home health industry.
  • Review new payer contracts and update system and internal procedures to accommodate contractual terms.
  • Establish quality and quantity goals for the department and monitor progress against standards.
  • Recommend, develop, promote, and implement improvements to current methodologies.
  • Advise the Director on trends, problems, and issues related to the assigned portion of the Accounts Receivable.
  • Continuously identify and recommend required changes to ensure compliance with rules/regulations related to billing and reimbursement through research and documentation.
  • Monitor and create a culture of compliance.
  • Maintain acceptable standards of attendance, punctuality, dependability, and productivity.
  • Enforce credit balance policy.
  • Analyze remittances, collection logs, write-offs, and claims billing relative to interoffice contracts for staffing and transfers for proper posting and assure the integrity of all transactions.
  • Maintain the integrity and confidentiality of all client and employee files as appropriate.
  • Review, advise, and manage payer profiles within systems, including rate tables.
  • Independently write reports, business correspondence, and procedure manuals. Effectively present information and respond to questions from groups of employees, managers, directors, and clients.
  • Independently create financial reports and provide detailed analyses.
• Talent Development:
  • Independently complete performance evaluations.
  • Autonomously engage in ongoing career planning and developmental conversations with staff and consult with the Director on a regular basis.
  • Responsible for the development of well-qualified employees to support reimbursement activities as well as the culture and vision of the organization.
  • Independently participates in the hiring process, onboarding process, and performance management of employees. Consult and advise the director of staffing needs, training requirements, and employee performance discrepancies.
• Customer Service:
  • Establish relationships with third party