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Director

Company: American Addiction Centers
Location: Hollywood
Posted on: May 3, 2021

Job Description:

Company Summary

If you are searching for a fulfilling place to develop your career and an opportunity to make a difference in helping others, then keep reading on. Here at AAC, we have a progressive culture; we listen to your ideas, value a work/life balance, invest in education, and we foster trust and respect for all individuals. Our exceptional comp and strong benefits include company matching 401K, medical, dental, vision and life insurance. We are looking for our future leaders, who are not only going to fill the qualifications for this job description, but who are going to exceed expectations. Be a part of a team whose mission is to provide quality, compassionate, and innovative care to adults struggling with addiction and co-occurring mental health disorders.Our purpose and passion are to empower patients, their families, and our communities by helping individuals achieve recovery and optimal wellness of the mind, body, and spirit.

Job Summary

The Director of Business Service provides leadership and effective and efficient management of financial services and utilization review in the organization. The Director of Business Services will oversee the Business office and Utilization Review Department Staff and functions. DBS will determine and explain clients financial responsibility and ensure the highest reimbursement assumed for render services through insurance authorizations, private admission and TPA funding types. Ensure funds are properly recorded, processed and deposited. The DBS will delegate case load and ensure the clients are covered at the appropriate level of care. This position will provide day to day supervision of the utilization review department, business office, administrative assistant and the billing/data entry assistant which includes monitoring workflow, time & attendance, and training of new employees. This position requires the ability to independently manage all network-related, payor- specific admission performance metrics. Identify root cause issues related to extended care and reimbursement, identify solutions and present meaningful analysis.


Duties and Responsibilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Monthly Reporting Cash Audit, Authorization Denial
  • Create payment list for clients missing payments on account.
  • Set up payment arrangements for past due balances.
  • Verify new benefits for clients via online and phone.
  • Review and process refund request for the facility.
  • Update UR census data with new admissions and level of care
  • Review Financial form list/ Complete/Explain financial forms for all new clients.
  • Manage the client prescription and personnel spending accounts.
  • Run payment records and reconcile weekly payments.
  • Review client insurance accounts for plan information.
  • Provide benefit consultation to clients.
  • Answer incoming statement calls from discharged client regarding billing/claims
  • Pre-certify insurance clients by completing reviews as needed with insurance companies to extend the stay of client in treatment.
  • Work with Clinical and Client Care Teams to communicate insurance case managers request for specific treatment, followups, and indidivudalized care
  • Communicate authorizations to clinical team
  • Prepare for weekly meetings to discuss appropriate discharge dates based on authorizations.
  • VA admission review for RES/Quality
  • Complete Financial Covered-Through dates in SalesForce
  • VA Rx log and audit quartlerly report analysis
  • Create TEP and TEC SalesForce new charges and payments
  • Assist clients making COBRA payments/ monthly
  • Complete third level appeals to overturn denials
  • Negotiate SCA
  • Reconcile Aura Spending Accounts
  • Review & Reconcile Refund, Patient Billing Accounts, Cash Collection
  • Update benefit and demographics information in Salesforce.
  • End of Year Reverifications
  • Review & Delegate BO Task- COB, AOB, ACA, EV
  • Participate in leadership meetings as required.
  • Process and review all facility refund request for accuracy.
  • Review each level of care with Clinical Director for each client.
  • Perform research analytics on past claims, authorization, payors and admissions
  • Continued learning education and update on all payor changes
  • Exude excellent professional communication abilities, at all levels within the organization and patients at all times
  • Make discharge recommendations with Ur Director based on financial criteria.
  • Work with UR department to ensure that authorizations are in the system timely and accurately.
  • Update all funding type when client conversion has been completed
  • Review and approve all private negations for extended treatment
  • Provide oversite to the facility supply management outside of maintenance, housekeeping and nursing needs
  • Management ONLY Essential Job Duties and Responsibilities
  • (please mark N/A if not applicable)
  • Responsible and accountable for managing direct reports
  • Preparation and presentation of performance evaluations
  • Provides objective feedback to employees
  • Makes appropriate compensation recommendations, if applicable
  • Provides appropriate training for department and hold staff accountable for attending required training
  • Provide actionable coaching solutions to the correct process, procedure and best practices
  • Holds interviews for vacant positions and makes appropriately selects candidates to fill open positions
  • Monitors adherence to company and department policies, procedures and practices
  • Creates and supports a positive, professional, team-oriented, harassment free work environment by understanding and complying with the companys policies
  • Responsible for verifying and approving UR/ BO Department time records in the time & attendance system. This includes entering time edits submitted by the employees, approving PTO, and approving the timecard at the end of each pay period.
  • Work with HR Director to control overtime and manage employee issues.
  • Collaborate with CEO for reimbursement improvements
  • Lead the UR meetings when Facility CEO is unavailable
  • Completes UR/BO Competencies
  • Provide ongoing training and resources to supervised staff

Facility-Specific Duties & Responsibilities

  • Follow up with UR team on missing authorization and new admissions.
  • Weely UR/LOC Clinical Meeting

Education/Experience:

  • Bachelor's Degree in Business Administration, and/or Nursing or Mental Health License preferred with combined five years sales experience.
  • 3-5 years high-volume sales/collections experience and understanding of KPIs including cash collected, conversion rates, etc.
  • 3-5 years supervisory/management experience
  • Business/ Industry Knowledge: Minimum of 2-5 years of direct industry experience negotiating provider contracts and/or provider relations. Strong understanding of health care network product spectrum and contracting, reimbursement methodologies including advanced knowledge of value-based designs. Must have strong knowledge of claim coding (CPT/DRG, etc.), provider networks, benefit designs, healthcare products/funding, medical management programs, authorization and financial acumen.
  • Strong communication skills: Able to articulate (verbally and written) complex business results, issues and strategies in a clear, concise and confident manner to all levels and positions of an organization (internal and external).
  • Relationship management: Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
  • Strategic Thinking: Must have demonstrated ability to think strategically in an independent manner and out of the box versus accepting the status quo, with minimal supervision.
  • Technical Skills: Must possess strong technical skills in Microsoft Office Applications (Excel, Word, PowerPoint) as well as experience using analytic/reporting applications
  • Ability to establish performance targets and history of achievement goals.
  • Ability to multi-task and successfully prioritize workload.
  • Willingness and ability to work in a fast-paced working environment over an extended period of time.

Physical Requirements

AAC is committed to principles of equal opportunities for all employees. The Company will provide reasonable accommodations that are necessary to comply with State and Federal disability discrimination laws

  • Ability to sit, use hands and fingers, talk or hear, and smell continually. Ability to stand, walk and reach frequently. Ability to climb or balance, stoop, kneel, or crouch occasionally.
  • Ability to frequently lift and carry up to 10 lbs. and occasionally lift and carry up to 25 lbs.
  • Close vision required to see computer monitor, read documents, and operate copy and fax machine. Distance vision required to drive an automobile, if driving is a requirement of the job.
  • Work environment is indoors and climate controlled. Occasionally exposed to outdoor weather conditions.
  • Moderate noise levels as found in a business office with computer printers, households with TVs and dishwashers, and driving light traffic.

American Addiction Centers is an equal opportunity employer. American Addiction Centers prohibits employment practices that discriminate against individuals or groups of employees on the basis of age, color disability, national origin, race, religion, sex, sexual orientation, pregnancy, veteran or military status, genetic information or any other category deemed protected by state and/or federal law.

Keywords: American Addiction Centers, Hollywood , Director, Other , Hollywood, Florida

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