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East Carolina University · 4 months ago

Manager of Accounts Receivable and Coding

Greenville, NC

Full-time

Onsite

Mid Level

$55K/yr - $62K/yr

East Carolina University is seeking a Manager of Accounts Receivable and Coding for their School of Dental Medicine. The role involves overseeing accounts receivable functions, managing coding operations, and ensuring compliance with billing regulations while providing leadership and support to staff.

Responsibilities

This position is responsible for the core accounts receivable (AR) functions including account resolution and collection of claims (~$16 million annually), workflows for B&F staff to optimize collections, determination of appeals of denied claims; and division of responsibilities between B&F and CSLC staff as it relates to account collection and resolution

The position also oversees all aspects of coding and its integration with: account collection, in collaboration with the Manager, Cash Management and Claims the interface of coding related to pre-submitted claims, and the overall communication and education/training of coding with Faculty and Students, including annual changes in codes and/or their interpretation

The Manager of Accounts Receivable and Coding also is responsible for the composition and administration of the SoDM’s prospective audit, communications with Faculty to discuss claims which require changes, education of both Faculty and students on aspects of coding their services and specific coding interpretations

Also, interfacing with and alignment with the Office of Institutional Integrity (OII) on any external coding audits or inquiries

The Manager, Accounts Receivable and Coding manages the business functions of outstanding receivable accounts for both insurance and patients, interpreting insurance company billing policies, implementing internal policies to determine; which claims are considered resolved, under what auspices denied claims will be considered unresolved and appealed, and which amounts unpaid by insurance will be transferred to patients

This position must translate broad policies and procedures from State and Federal Governments and University Departments to develop and maintain sustainable operating procedures

The Manager, Accounts Receivable and Coding is responsible for primary reporting and compliance components of these elements of SoDM’s Revenue Cycle

This includes, but is not limited to, established organizational and industry metrics such as days in AR, AR aging, percentages of denials, net collections, and overall collections

The position develops and analyzes financial data for patterns to help find accounts which might otherwise go undetected for lack of or incorrect payment in order to improve SoDM revenue collection; and must have current knowledge of billing regulations, clinical coverage policies and insurance industry changes, in particular any/all changes related to coding as the organization’s subject matter expert on coding

This position is also responsible for the coding operations and monitors all processes, procedures and business activities as it relates to the operation of the prospective audit, working with and under supervision of the Director

Also determines, in collaboration with the Director, the composition of the audit, including which codes, which clinics or providers, and what percentage of a provider’s or code’s claims are included in the audit in order to optimize the impact on compliance with industry standards for documentation, dental record accuracy and appropriate reimbursement

The position supervises two FT Advanced Accounting Technicians – Remittance, one University Program Associate, and 1.75 FTE Coders

The position provides leadership, administrative direction and training in the development of processes, policies and systems that contribute to successful business operations

The position applies techniques, practices and procedures and robust continuous improvement efforts in both dental/clinical operations and financial operations to optimize performance in a rapidly changing regulatory and operational environment

Promotes employee engagement, motivation, retention and optimal performance in a cooperative, goal-oriented culture

The position develops policies and procedures to insure appropriate internal controls of all clinical billing reconciliation and appropriate designation of expenditures to meet generally accepted accounting principles and the application to cost, governmental accounting, and non-governmental accounting

Maintains job descriptions that reflect the current work responsibilities of staff

This position requires an in-depth knowledge of current dental and medical insurance payor guidelines and regulations, as well as dental business office operations

Incumbent should understand and be able to optimize processes for account collection and reconciliation, ongoing high-volume coding audits, communication and training for B&F staff to prevent future denials and for faculty and students to improve coding accuracy

It is imperative that the role works with faculty, students, other Managers and staff in a professional and highly collaborative manner

Working with the support of the Director and Manager of Cash Management and Claims in Business and Finance, apply monitoring tools and meet established metrics for performance standards under position’s control

Such standards include but are not limited to; timely appeals of claims, timely response to B&F staff inquiries, coordination of post-submission revenue cycle processes with pre-submission processes

Supporting the Director, and working with the Manager of Cash Management and Claims, work to meet overall departmental and organizational standards such as, but not limited to; Days in AR, AR aging, percentage of dentals, net collections and overall collections

Role requires a super-user level of expertise with the axiUm system, the School’s Dental Management Software System, as well as competence in university systems such as Business Intelligence, to link technology to process to people most efficaciously in accomplishing all of the above

Work effectively in a team environment, with other B&F management staff, Clinical Affairs and CSLC management and their staff, with other internal University Departments (e.g. Office of Institutional Integrity (OII), Internal Audit) and external stakeholders such as insurance companies (e.g. Delta Dental, United Healthcare, etc.) and private and public (e.g. North Carolina Department of Revenue) entities

This position independently resolves, collaborates with peers, and makes recommendations to resolve complex issues and problems, and serves as a trainer and resource to SoDM

This position provides support and training for all post-claims submission revenue cycle related issues both for all SoDM clinics at Ross Hall as well as at remote operations including Community Service Learning Centers (CSLCs) and GPR

Role requires a focus on best practices in terms of processes and operations, as well as working towards standardization of practice across all SoDM clinics and continuous improvement

This position oversees all customer service elements of the revenue cycle, insuring staff provide accurate, professional and customer-centric service to internal stakeholders or patients with questions or issues with their SoDM accounts

In support of the Director and B&F, conduct analyses, document findings, prepare presentations, provide recommendations and execute agreed upon plans

Keep current knowledge of the payor, regulatory issues and active in applying operational changes necessary to optimize functions in this changing environment

This position anticipates problems and develops recommendations for management resolution

Qualification

Accounts Receivable ManagementCoding ExpertiseHealthcare Billing KnowledgeFinancial AnalysisPolicy DevelopmentAnalytical SkillsCommunication SkillsTeam Collaboration

Required

Bachelor's degree in business administration, public administration, or related business area; or equivalent combination of training and experience. All degrees must be received from appropriately accredited institutions