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Humana Inc

Associate Director, RCM Accounts Receivable

Humana Inc, Topeka, Kansas, United States

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Become a part of our caring community and help us put health first This is a hybrid position; 1 day in office/4 days remote. Must live within the greater Kansas City metropolitan area.

Overview Responsible for healthcare claims accounts receivable operations in accordance with Company policies and procedures. Meets or exceeds established cash collections and Day Sales Outstanding (DSO) goals. Works directly with program, branch, area, regional and divisional leadership, and external payers to effectively manage end-to-end claims processing activities. Performs all duties inherent in a managerial role including staff selection, development, corrective action, succession planning and team building. Prepares departmental budget and monitors expenses to ensure compliance with approved budgetary expectations.

Responsibilities

Directs accounts receivable activities to maximize reimbursements. Ensures accurate, timely billing and collection. Develops credit/collection strategies and implements plans to ensure accounts receivable balances are within stated objectives.

Ensures appropriate staff development, training and succession planning. Evaluates staff performance, and is responsible for department hiring, terminations, promotions and salary actions.

Serves as Company liaison to state, federal and third-party payers.

Participates in company leadership meetings at the branch, area, regional and divisional level and ensures proactive and effective communications with field management.

Provides company leadership with updates on accounts receivables. Assists in developing branch-specific plan of correction as needed.

Continu continually assesses operational efficiencies and implements continuous improvement processes. Works with internal business partners on reimbursement issues and in maintaining SOX compliance.

Establishes monthly FSU goals and evaluates performance on cash, DSO and budget metrics. Develops action plans accordingly.

Maintains knowledge of current regulations, policies and procedures of state, federal and third-party reimbursement programs and assists staff in interpreting and applying technical and business requirements.

Prepares departmental budget and monitors expenses to ensure compliance with approved budgetary constraints. Ensures that sales adjustments and write-offs are properly approved and processed.

Interacts with internal business partners to improve processes and procedures to achieve overall company accounts receivable goals. Reviews payer contracts for proper billing to achieve accurate revenue recognition.

Drives change throughout the organization and makes contributions to the company’s goals and objectives by improving performance of self, team and business.

Establishes credibility with customer base and demonstrates interpersonal, collaborative, and relationship-building skills.

Demonstrates ability to communicate difficult or sensitive information and manage new business processes.

Manages multiple projects, deadlines and priorities and collaborates and influences across functions and at all levels of the organization.

Accountability for self and others, facilitates synergy throughout the organization and executes on agreed-upon goals and objectives in a timely manner.

Performs other related duties as assigned.

Requirements

Bachelor’s Degree in Healthcare administration or the equivalent preferred

A minimum of 7 years healthcare related billing/collection experience preferred

A minimum of 5 years in a management role generally required

Experience with Electronic Medical Record (EMR) systems and technology related to collections/billing; Homecare Homebase system experience preferred

Proficiency in Microsoft Excel, Word, Outlook

Strong knowledge of accounts receivables procedures and general accounting principles

Excellent organizational and verbal/written communication skills

Strong time management, critical thinking and innovative problem solving skills; ability to identify and develop talent through coaching, mentoring, and training

Approximate percentage of time required to travel: 10%

Additional Information

Internet requirements for home or hybrid work: minimum download speed 25 Mbps and upload speed 10 Mbps; wired, wireless, cable, or DSL connections acceptable.

Satellite, cellular and microwave connections require leadership approval.

Employees in California, Illinois, Montana, or South Dakota working from home will receive bi-weekly internet expense payments.

Home or Hybrid Home/Office employees will have telephone equipment provided to meet business requirements.

Work from a dedicated space free from ongoing interruptions to protect member PHI / HIPAA information.

Benefits and About Us CenterWell Home Health offers a variety of benefits to support the health and well-being of employees and their families, including:

Health benefits effective day 1

Paid time off, holidays, and jury duty pay

Recognition pay

401(k) with employer match

Tuition assistance

Scholarships for eligible dependents

Caregiver leave

Employee charity matching program

Network Resource Groups (NRGs)

Career development opportunities

Travel: Although this is a remote position, occasional travel to Humana’s offices for training or meetings may be required.

Schedule and Compensation Scheduled Weekly Hours:

40

Pay Range:

$115,200 - $158,400 per year. This position is eligible for a bonus incentive plan based on company and/or individual performance.

About Humana / CenterWell CenterWell Home Health is a Humana company focused on whole-person health and comprehensive home care. CenterWell provides stability, benefits, and growth opportunities across a large network of clinicians and services. By providing flexible scheduling, career development programs, and coaching, CenterWell supports employees from day one.

Equal Opportunity Employer Humana does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. We comply with applicable laws including Section 503 of the Rehabilitation Act and VEVRAA. All employment decisions are based on valid job requirements.

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