This position is responsible for receivables management 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, coaches, 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, coaches, and develops employees through orientation, training, establishment of objectives, communication of policies and rules, and constructive discipline; builds 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.