Business Integrity Services

6 days ago

Tiruchirappalli, India BUSINESS INTEGRITY SERVICES PRIVATE LIMITED Full time

Job Title: Associate Director Insurance AR (Hospital Billing)Department: Insurance ARLocation: TrichyReports To: VP OperationsJob Summary:- The Associate Director Insurance AR will be responsible for leading and managing the hospital billing Insurance and Patient AR operations across inpatient, outpatient, and emergency services. - The role involves overseeing end-to-end revenue cycle activities, ensuring billing accuracy, compliance, process efficiency and timely collections to optimize financial performance. The position requires strong analytical, operational and leadership capabilities to drive process improvement and ensure adherence to quality and compliance standards.Key Operations Management: - Oversee and manage the end-to-end hospital billing process primarily focused on Insurance and Patient AR, including charge capture, claim submission, coding denial review and payment - Ensure accuracy and timeliness of billing for inpatient, outpatient and ancillary services.Monitor daily billing volumes, rejections and backlogsto maintain operational efficiency.Team Leadership & Performance Management: - Lead a large team of billing executives, leads, and managers across different shifts or units.- Set clear performance goals, conduct periodic reviews, and drive accountability.- Provide training and mentoring to enhance team performance and domain knowledge.Compliance & Quality Control: - Ensure adherence to payer policies, audit requirements, and hospital billing guidelines. Conduct internal audits to minimize denials, rework and compliance risks.- Collaborate with coding, AR, and denial management teamsfor seamless processflow. Revenue Optimization & Reporting- Track key RCM metricssuch as DSO (Days Sales Outstanding), billing accuracy, and clean claim rate.- Analyze billing trends, root causes for rejections, and recommend process improvements.- Prepare and present periodic performance dashboards and MIS reports to seniorStakeholder Collaboration:- Partner with medical, finance, IT, and insurance departmentsto resolve billing-related issues.- Liaise with clients, payers, and auditorsfor escalations, reconciliations, and clarifications.- Support implementation of new billing systems or process automation & Strategy:- Identify areasfor automation and processstandardization to improve TAT and accuracy.- Supportstrategic planning forscaling billing operations and workforce optimization.- Contribute to policy formation, SOP documentation, and quality assurance frameworks.Key Skills & Competencies:- Strong understanding of hospital billing insurance AR, charge capture and RCM workflows.- Expertise in CPT/ICD coding, DRG codes, payer policies and denial management.- Proficiency in hospital billing software (EPIC, Allscripts, NextGen, HST, Intergy, HIS, Meditech, Cerner, Athena, or similar).- Analytical mindset with ability to interpret financial and operational data.- Excellent leadership, communication, and stakeholder management skills.- Ability to drive process excellence and lead large cross-functional teams.Qualifications & Experience:- Bachelors or masters degree, Healthcare Administration, or related field.- 10 - 15 years of experience in hospital billing or healthcare RCM, with at least 5 7 years experience in a managerial/leadership role.- Detailed work experience in hospital billing mandatory.- Strong knowledge of healthcare compliance standards and audit requirements (ref:iimjobs.com)

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