Account Control Officer

Job Description:

Overview:

The Income Manager/ACO is responsible for overseeing the accuracy and efficiency of the billing department while ensuring compliance with insurance regulations and policies. This role involves managing a team, setting production and collection targets, monitoring financial performance, and ensuring timely billing and collections for services rendered. The Income Manager/ACO will contribute to company-wide financial goals by ensuring effective billing procedures and collection practices.

Key Responsibilities:

• Team Management:

Oversee and manage the Insurance Verification Officer, Billing Officer, and EOB Officer to ensure accuracy, efficiency, and compliance with company standards.

• Regulatory Compliance:

Stay up-to-date on insurance regulation changes and ensure the team is educated on these updates.

• Monitoring Financial Targets:

Track weekly production and collections, including billing out the door and estimated collection targets.

• Investigate Insurance Trends:

Analyze and address any downturns or trends with specific insurance carriers.

• Write-Off Reviews:

Review all write-off requests to ensure all collection efforts have been exhausted before approving.

• Setting Targets:

Establish weekly production and collection targets to ensure the company's yearly financial goals are met.

• Over-the-Counter Collections:

Enforce policies for over-the-counter collections to minimize the need for post-discharge collection procedures.

• Weekly Department Review:

Analyze weekly statistics from the billing department and provide guidance to junior staff, creating a battle plan for the team each week.

• Aged Accounts Management:

Monitor the A/R report and work with aged accounts over 45 days old to ensure no more than 15% of total outstanding GI is over 90 days old.

• Litigation & Special Cases:

Ensure that all litigation cases, workers' comp cases, and private pay clients understand their legal responsibilities and the company's collection policy procedures.

• Timely Billing:

Ensure that all billing, both for insurance companies and patients, is completed promptly and follows a regimented program of letters, emails, and phone calls for collection.

• Reporting:

Submit monthly reports to the CEO/Owner, highlighting trends and insights to be discussed at the end of each month.

• Collaboration:

Actively participate in meetings and collaborate with other departments, including the front desk, to maximize over-the-counter collections from all patients.

• End-of-Month Reporting:

Participate in the end-of-month meeting with the CEO/Owner and MSO Regional Managers (if applicable) to report on billing stats and financial performance.

Key Metrics and Goals:

• Collections Performance:
• Ratio of cash collections to billed amounts.
• Percentage of payroll as a portion of gross income (GI).
• Calls and Billing Efforts:
• Number of collection calls made to patients per week.
• Number of collection calls and correction calls made to insurance carriers.
• Number of claims re-billed and total amount re-billed.
• Amount collected via online payment platforms (website).
• Amount collected from patients via email statements.
• Production Metrics:
• Weekly production billed out.

Technical Requirements:

Qualifications and Skills:

• Proven experience in account management, billing, or financial control within a healthcare or insurance-related environment.
• Strong leadership skills with the ability to manage and mentor a team.
• In-depth knowledge of insurance verification, billing, and collection processes.
• Excellent organizational and time-management skills.
• Ability to analyze financial reports and identify trends.
• Strong communication skills to effectively collaborate with internal teams and external clients.
• Attention to detail and a proactive approach to resolving billing issues and minimizing outstanding balances.

Required Experience:

• Previous experience in a billing, collections, or account control role.
• Experience with insurance verification, billing software, and financial tracking tools.
• Understanding of medical billing regulations and insurance policies.
• Experience in setting and achieving financial targets and goals.