Third Party Director of Revenue Cycle

  • Milford, MA, USA
  • Full-time

Company Description

Human Services Management Corporation (HSMC) provides shared business and consulting services to both non-profit and proprietary human services agencies. These services include accounting, payroll, third-party billing and collections, human resources, online and live Continuing Education, marketing, facility development and quality assurance programs.

Job Description

We are currently seeking a Third Party Director of Revenue Cycle who will be responsible for making the day to day decisions of the Billing/Collections/AIMS areas and will direct and coordinate the overall functions of the business office to insure maximization of cash flow, while improving internal and external relationships.

Responsibilities will include the following:

  • Oversees the operations of the Third Party department; including coding, charge entry, claims submissions, authorization & intake functions, and collections (which includes insurance, private pay and contracts) 
  • Serves as the “go to” person for all intake, authorization, coding, billing and collection processes
  • Plans and directs insurance documentation, workloads, and data processing to ensure accurate billing and collections
  • Maintains contact with other departments to obtain and analyze additional information needed to document and process accurate billing, minimizing the denials received by the collectors
  • Analyzes trends impacting charges, coding, collection and accounts receivable and take appropriate action to realign staff and revise policies and procedures
  • Supervision of the Third Party staff which includes work allocation, training, and assisting with achieving productivity and performance goals
  • Participates in contract negotiations with third party payers
  • Oversees specialty billing and contracts related to The Vanguard Group
  • Oversees specialty contracts with school districts, CCSD and other contracts as assigned
  • Acts as a system control for the EHR and Patient Accounting Systems, coordinating the addition of Funders, Service Lines, and CPT codes used for charging and billing

Qualifications

  • Associate's Degree in Business Administration, Accounting, Health Care Administration or related field required
  • Successful completion of a program in medical billing or current Certified Medical Reimbursement Specialist (CMRS) certification will be considered in lieu of degree requirement
  • 5 years of medical insurance/healthcare billing and collections experience in a medical practice or health system
  • 3 years of supervisory or management experience preferred
  • Experience in CPT and ICD-1- coding and familiarity with medical terminology
  • Must have high attention to detail and be extremely organized
  • Able to multi-task and have very strong communication skills

Additional Information

Our Benefits:

  • Medical & Dental Insurance
  • Flexible Spending Plan
  • 401k with company contribution
  • Voluntary Benefits
  • Paid Time Off (Sick, Vacation, Holidays)
  • Tuition Reimbursement
  • Staff Events (Foxwoods, NYC, Six Flags)

Please visit our website at www.hsmc.org to learn more about our organization!

Selection for employment is made regardless of race, color, religion, creed, sex, sexual orientation, gender identity/expression, pregnancy or pregnancy-related condition, marital status, national origin, ancestry, age, disability, handicap, genetic information, someone who is a member of, applies to perform, or has an obligation to perform, service in a uniformed military service of the United States, including the National Guard, on the basis of that membership, application or obligation; veteran status, or any other bases protected by law. HSMC participates in E-Verify.