Director, Accounts Receivable Business Management

The Director of Hospital Accounts Receivable Business Management is responsible for leading comprehensive cash management strategies and overseeing denials, appeals, and candidate-for-billing processes.

Key Responsibilities

Cash Management:
* Develop and oversee hospital cash strategies, reconciliation processes, and automation.
* Ensure adherence to institutional policies and regulatory requirements.
* Lead cash collection and error reduction initiatives.
* Collaborate with Hospital Financial Reporting and Physician Organization Accounting teams.

Denial Management:
* Conduct root cause analysis to identify denial trends and drive improvements.
* Lead the Denial Management Oversight Committee (DMOC).
* Develop denial accountability models across all revenue cycle areas.
* Produce and present comprehensive denial trend reports.

Appeals Management:
* Oversee timely and effective resolution of denied claims.
* Monitor appeal outcomes and refine strategies.
* Enforce accountability models across revenue cycle areas.

Candidate for Billing Oversight:
* Manage timely resolution of edits in the candidate-for-billing process.
* Track volumes and optimize success rates.
* Maintain accountability across departments for performance improvement.

Stakeholder Collaboration:
* Partner with clinical, IT, and billing teams to address denial causes and automation opportunities.
* Align strategies across stakeholders to reduce rejections and enhance workflows.

Process Improvement:
* Implement continuous process improvements and workflow enhancements.
* Leverage data analytics to monitor performance and inform strategy.

Regulatory Compliance:
* Stay current on healthcare regulatory changes.
* Ensure all related processes meet compliance standards.

Leadership & Team Development:
* Lead, mentor, and develop a high-performing team.
* Foster a culture of accountability, collaboration, and innovation.

Required Qualifications

* BA degree in Finance or related field: MA degree preferred.
* Relevant certifications such as CPC, COC, AHIMA-CCS, RN, RT, MT, RPH, or PMP are highly desirable.
* 10 years of experience in hospital finance or revenue cycle management, with significant exposure to cash management and denial/appeals processes.
* Proven experience in process improvement and regulatory compliance within a healthcare setting.
* Strong leadership skills with a track record of developing high-performing teams.
* Excellent analytical, problem-solving, and communication skills.
* Proficiency with financial management systems and data analytics tools.
* Ability to manage multiple projects and negotiate with peer level leaders on issues affecting both the department and the broader hospital organization.
* Strong knowledge of end-to-end healthcare revenue cycle operations.
* Ability to communicate effectively and collegially, including empathetic communication in challenging situations.

Boston Children's Hospital offers competitive compensation and unmatched benefits.