This position is responsible for receivables administration and project management for the receivables assigned. Responsible to know United States Healthcare regulations, pharmacy industry end to end workflow, and subsidiary receivable system(s) end to end workflow. Responsible to drive collections, cash flow and minimize uncollectible losses. Responsible to ensure compliance with regulatory and contractual requirements. Responsible for providing review of department results; financial and management reports; subsidiary accounts; and department results for area of responsibility, ensuring team's activities, reports, and results are within goals and are in compliance with regulations, accounting principles and company policies. Mentors, guides, and develops employees.
- Responsible for accuracy of the financial and management reports and subsidiary accounts for area of responsibility. Presents results to Accounting Management.
- Establishes and maintains relationships and networks with all departments and appropriate outside contacts that interact with the department.
- As applicable, responsible for BPO and service provider oversight.
- Leads team to resolve escalated internal and external customers to obtain required information, documents, or payments. Responsible for handling resolution of escalated collections, audits and customer service issues. Focus on payer relationships to ensure timely collections and resolution of escalated issues.
- Manages accounts receivable billing and collections for assigned Payers. Ensure timely cash flow and minimization of uncollectible receivables. Research and correction of escalated issues and exceptions related to collections, potential overpayments and projects assigned.
- Ensures team’s activities and reports are in compliance with U.S. (Federal & State) Healthcare regulations, Payer Contract terms, accounting principles and adheres to company policies. Implements new compliance, receivable and accounting policies and ensures those policies are communicated to team as well as the business unit. Writes/approves departmental procedures. Ensures all necessary approvals are obtained before implementation.
- Audits compliance with contracts, negotiated terms, and applicable regulations and takes necessary steps to resolve issues. Responsible for both internal and external communications to resolve issues and for communications to management for non-compliant items.
- Prepares and/or reviews reports in support of internal and external audits. Works with internal and external audit as needed. Responsible for resolution of open items.
- Addresses training and reviews audits of work of team members and BPO / service providers for accuracy and timeliness.
- Mentors, guides, and develops employees through orientation, training, establishment of objectives, communication of policies and rules, and constructive discipline; strengthens morale and motivation.
- Responsible to review departmental results and recommend corrective action plans as necessary. Proposes improvement recommendations for systems, workflow and procedures. Works with cross functional teams for proper implementation.
- Develops and implements strategic guidelines, procedures and processes as required.
- Develops relationships with Payers, Government jurisdictions, BPO/service providers, customers and other Walgreen departments to ensure positive interactions, resolutions, and outcomes of inquiries and issues and works in collaboration with other departments to make identified changes to improve processes.
Bachelor’s Degree and at least 2 years of experience in an accounts receivable related analytical role or High School Diploma/GED and at least 5 years of experience in an accounts receivable related analytical role.
Experience with applicable accounting and government regulations.
Experience with analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions.
Experience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems
Knowledge of financial accounting (e.g., receivable reconciliations, accruals, reserves), HIPAA guidelines, federal, state, and local regulations related to healthcare payers, billing and collections.
At least 1 year of experience of direct leadership and/or cross functional team leadership.
Willing to travel up to 15% of the time for business purposes (within state and out of state).
Bachelor’s Degree and at least 5 year of experience in an accounts receivable related analytical role with collections experience or High School Diploma/GED and at least 8 years of experience in an accounts receivable related analytical role with collections experience.
U.S Healthcare industry experience, end-to-end Revenue Cycle experience, and / or pharmacy workflow experience.
Master’s degree in Accountancy or MBA
Experience in leading cross functional teams under direct and indirect control to drive improved business results.
Experience in an outsourcing relationship.
Payer, Compliance or Legal audit and investigation experience
Experience with data mining and analytical tools
Intermediate level skill in Microsoft Access (for example:
designing and creating simple queries, modifying data types, adding dates, working with required fields and/or creating labels).
Intermediate level skill in Microsoft Excel (for example:
using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling).
Intermediate level skill in Microsoft Word (for example:
inserting headers, page breaks, page numbers and tables and/or adjusting table columns).
Intermediate level skill in Microsoft PowerPoint (for example:
applying a theme, formatting character spacing, inserting a picture, changing slide layout and theme colors, adding transitions, customizing slide numbers, changing chart style and/or formatting font).