Director Accounts Receivable

JOB SUMMARY: The Director of Accounts Receivable and Premium Recovery (ARPR) Department is responsible for directing the activities for the accounts receivable and premium recovery functions, including planning, providing strategic leadership, coordination and reporting information and establishing departmental operating practices and controls. The incumbent of this position is responsible for the overall direction and guidance of the Accounts Receivable and Recovery Departments.
Accounts Receivable management responsibilities include the design, development and implementation of an effective billing processes, collection, and reporting to meet various state contracts provisions and to facilitate the timely collections of premiums and other supplemental billable premiums/payments. Represent the finance department in assessing and making recommendations on accounts receivable related activities of new markets and acquisitions Responsible for directing the activities of the provider refund notification (RNF) process and streamlining its interactions with the CCU
Premium Recovery management responsibilities include the design, development and implementation of an effective recovery process, through identification of recoverable/payable amounts falling out of the premium reconciliation process and documentation of such amounts.

Establish a periodic review process of the accounts receivable and premium recoverable amounts to evaluate its collectivity and/or as a basis of establishing reserve for doubtful account and eventual write offs.

Understand the requirements of the general ledger team and develop an efficient and complete set of monthly reports that will provide adequate financial information and served as a source document for preparing journal entries. Prepare, review and approve journal entries identified by the Accounts Receivable and Premium Recovery Department.


PRIMARY RESPONSIBILITIES:

1. Implement procedures related to ARPR consistent with fiscal and contract requirements.
2. Develop and administer guidelines for the ARPR department.
3. Responsible for development and maintenance of OB delivery supplement accounts receivable application to include identification, billing and reconciliation of all accounts receivable activity. To include system enhancements and implementation for current contract changes and/or new acquisitions.
4. Responsible for the billing of the New York market. To include all processes related to Medicaid and CHIP premium billing, and the CHIP co-payment billing and tracking.
5. Responsible for all contract deliverables relating to premium supplements in all markets and the Medicaid premium billing in New York.
6. Responsible for the transition, set-up and billing for all new markets and acquisitions as they relate to accounts receivable processes.
7. Establish routine accounts receivable reporting to include accounts receivable due to claims, capitation and other billing processes. Routine reporting to include ageing, detail by provider of balance, and bad debt listing.
8. Reconciliation of accounts receivable balance per the general ledger to detailed subsidiary system.
9. Monitor Account Receivable and Premium Recovery activities to ensure conformance with contract requirements as applicable to premium payments and fiscal recovery.
10. Review and determine areas of improvement within the department and institute new procedures where required.
11. Prepare reports, analyzing data for potential areas of recovery, collection or write-off. .
12. Coordinate and oversee the implementation/acquisition of new markets for the ARPR Department.
13. Oversee the development of necessary technical and user documentation to assist in the support and training of the ARPR staff. Ensure the documentation of all policies and procedures and updates thereof.
14. Review and analyze contract proposals for impact on the ARPR.
15. Perform project management functions in achieving the timely completion of ARPR projects.
16. Report periodically to the AVP/SVP Finance the monthly transaction affecting ARPR.
17. Coordinate ARPR projects with other impacted departments.
18. Oversee the development of recovery programs to identify deficiencies in contractual requirements and secure appropriate fiscal reimbursement.
19. Monitor the collection and settlements on past due accounts. This is to include provider and employee advances.
20. Supervise the preparation and present the monthly accounts receivable and premium recovery analysis package to senior management for the monthly financial review.
21. Review for accuracy and oversee the timely distribution of the monthly reports.
22. Maintain and document quarterly SOX compliance for the ARPR processes.
23. Other duties as assigned or requested.
REQUIREMENTS
Education and Experience:
• Bachelor’s Degree in Information Systems, Health Care Management, Business or equivalent experience.
• Minimum of five years experience in Health Care industry, preferred.
• Five years progressively responsible experience managing and supervising operations area, required.
• Experience in HP systems environment, a plus.
• Experience in a team oriented and/or productivity oriented environment, helpful.
• Business or systems analysis experience, a plus.

Knowledge and Skills:
• Strong customer service orientation.
• Working knowledge Microsoft Access and AMISYS, a plus.
• Knowledge and experience using management information systems, database applications, word processing and spreadsheet applications required.
• Financial background preferred
• Detail oriented with excellent analytical skills, ability to identify problems and develop solutions.
• Strong project management skills.
• Strong communication, presentation and team work skills. Excellent written communication skills.
• Proven leadership skills at high organizational level.
• Ability to set priorities, meet deadlines, delegate tasks and coordinate several projects at once in a demanding work environment.
• Ability to function under pressure.
• Appreciation of cultural diversity and sensitivity towards target population.

Physical Requirements:
• Must be able to conduct and facilitate meetings.
• Must be able to operate a computer.
• Must be able to operate a telephone

In order to be considered for this (requisition #2945) positon please go to our website and apply online www.amerigroupcorp.com