Senior Manager, Commercial & Managed Care Collections

UC Irvine; Anaheim (CA); On-site; USD 95,000 - 125,000; Full time

Benefits offered by this job

Medical insurance

Sick and vacation time

Retirement savings plans

Job summary

UCI Health, California's premier academic health system, seeks a Commercial/Managed Care Collections/Denials Manager to lead hospital A/R, collections, and denial workflows for Commercial/Managed Care payers. You will train staff, analyze A/R performance, and ensure adherence to policies and regulations within Patient Financial Services.

The role requires extensive billing knowledge, leadership, and strong communication to coordinate with multiple departments and improve revenue recovery across

Qualifications

• Thorough knowledge of medical and insurance terminology, and of billing and / or collections internal procedures and external regulations.
• Strong time management and organization skills.
• Strong technical knowledge of CPT, HCPCS and ICD-10 coding, LCD, NCD, MUE, CCI, Modifiers, authorization requirements and related documentation.
• Strong interpersonal and communication skills to collaborate and effectively manage conflict with all constituent groups.
• Strong analytical and report writing skills to effectively comprehend multiple reports and analyze array into actionable form.
• Strong ability to facilitate accurate and timely billing and collections.
• Solid leadership skills to coach, mentor, and strengthen the team’s performance.
• Solid knowledge of human resources management policies, with the ability to evaluate and document human resources matters and performance.
• Solid critical thinking and decision‑making skills, with the ability to analyze and evaluate complex and/or difficult problems, determine appropriate level of intervention, and develop and apply viable solutions.
• Proficient in Microsoft Office and related programs (i.e. Microsoft, Excel, Outlook, PowerPoint, etc.)
• Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
• Must have the ability to maintain a pace appropriate to the workload
• Minimum of three (3) years of experience in billing and collections of Commercial, Managed Care, Medicare, Medicare Advantage, Medi‑Cal, CalOptima, FQHC, and CCS and other programs that fall under the scope of Government programs and commercial billing
• Minimum of five (5) years of related relevant experience in business office operations, consulting, or auditing
• Excellent verbal and written English communication skills including the ability to convey complex information in a clear, concise manner
• Demonstrated lead/supervisory skills to effectively oversee and prioritize staff activities and manage complex workflow and multiple priorities associated with billing and/or collections operations
• Demonstrated ability to use sound judgment
• Bachelor's Degree in related area and/or equivalent education/experience
• Ability to function independently and as a member of a team

Responsibilities

• Manage hospital accounts receivables (A/R) and the collections, denial, and workflow activities for Commercial/Managed Care payers.
• Provide training, manage work performance, A/R analysis, and corrective actions as needed.
• Act as liaison between Patient Financial Services and department leaders to resolve billing/denial issues and improve first-pass clean billing.
• Analyze key performance indicators, dashboards, and reports to optimize A/R disposition and revenue recovery.

Skills

Billing & collections knowledge

CPT/HCPCS/ICD-10 coding knowledge

Regulatory compliance

Leadership skills

Communication skills

Microsoft Office

Time management

Team supervision

Problem solving

Education

Bachelor's Degree in related area

Tools

EPIC

Job description

UCI Health, California's premier academic health system, seeks a Commercial/Managed Care Collections/Denials Manager to lead hospital A/R, collections, and denial workflows for Commercial/Managed Care payers. You will train staff, analyze A/R performance, and ensure adherence to policies and regulations within Patient Financial Services.

The role requires extensive billing knowledge, leadership, and strong communication to coordinate with multiple departments and improve revenue recovery across