Manager and Director of Healthcare Billing

Healthcare Facility needs a Director of Patient Billing – besides competitive salary possible Relocation Bonus!

$90-100k -possible relo Bonus

Description

Major Responsibilities:

· Analyze current billing practices and recommend changes to improve the revenue cycle process.

· Develop/revise billing policies and procedures as required to address changes in reimbursement, payor policies, and other regulatory or third party guidelines.

· Manage and report on aged accounts receivable, days in AR, and avoidable denials in accordance with best practice benchmarks. Ensure that department deadlines are met in a busy environment.

· Recommend and implement policies, procedures, and processes to improve efficiency and effectiveness of front end revenue cycle processes and provide reports to key stakeholders on the performance of the key performance indicators. Develop methods of measuring results and providing feedback on key initiatives.

· Evaluate and make recommendations on information system enhancements and new information technology as required to provide overall effectiveness and efficiency.

· Establish and maintain a professional, team-oriented environment where employees are motivated to comply with all aspects of reimbursement regulations, effective AR management, and customer service standards.

· Maintain current working knowledge of all professional reimbursement issues. Meet periodically with Senior Managers to review revenue cycle data and receivables.

· Mentor and train department staff and management.

· Perform all other job-related duties that may be assigned.

· Demonstrates understanding and commitment of the health center mission.

· Demonstrates understanding and commitment to the established company Values and Standards.

REQUIRED QUALIFICATIONS:

Eight years of experience in third-party billing and collections. Strong knowledge of ICD10 and CPT coding, contract compliance and information reporting requirements.

· Experience managing a large professional fee billing operation with a demonstrated track record of success in achieving effective AR management to best practice benchmarks.

· Minimum of five years of RCM experience.

· Bachelor’s Degree required; Master’s Degree is preferred.

· Previous experience working with NextGen software strongly preferred.-will see other

· Strong interpersonal skills.

· Strong analytical skills and ability to implement changes effectively and timely

Billing Manager – Healthcare $60-70k Salary — Supervise 4-5 billing specialist

Description

Essential Duties and Responsibilities:

· Prepares and analyzes billing office financial reports in a timely manner

· Setting up, maintaining, and reconciling all EDI transmissions received and transmitted out of the NextGen system

· Setting up EDI customer profiles by determining electronic capabilities with external customers

· Maintaining supporting documentation for all billed invoices

· Ensuring all payments are posted timely

· Researching, escalating and resolving any billing discrepancies

· Ensuring that claims are filed accurately and within the time limits required for each payer

· Working with payers to resolve outstanding claim processing issues

· Addressing and resolving account credit balances on a weekly basis

· Researching, escalating and resolving any denied claims either identified from aged accounts reports or payer remittances within required filing time limits

· Tracking incoming EDI file names, dates, claim counts, and fatal edits, including logged, run and process files

· Maintaining and updating mapping setups to support trading partners profiles

· Communicating with internal departments, as well as contracted providers, concerning submittal issues that require troubleshooting

· Providing feedback to internal departments about issues on the front end that are impacting the department

· Responsible for managing CHC’s relationship with Clearinghouse vendors as well as with the various insurance companies (i.e. Medicaid, Medicare, HSN)

· Ensuring that the NextGen system is updated with the correct fee schedules and contractual allowances

· Monitoring all changes in fees with the various payers and ensuring the system is updated timely

· Resolving of any collections issues for self-pay balances as needed

· Overseeing the credentialing process and staff to ensure this function is performed timely and accurately

· Managing accounts receivable weekly by reviewing aging/collections reports and ensuring claims are being resolved or written off timely

· Overseeing the month-end process by ensuring that all transactions necessary for the given month are completed timely

· Identifying and processing any requests for system changes

· Demonstrating an understanding and commitment of the health center mission

· Demonstrating an understanding and commitment to the established CHC Values and Standards

· Performing all other duties as assigned by supervisor

Minimum Qualifications:

· 5- 7+ years of experience in medical third party billing environment dealing with both billing and

· Experience with Electronic Data Processing (EDI).

· The individual needs to have solid EDI experience – comfortable with queries, loading files, working on issues with IT and other

· The individual should be familiar with IDC10 and CPT Coding and a CPC is a plus. NextGen experience

Qualifications

Skills

Required

Microsoft Office Experience (Word, Excel,etc)

Advanced

Medical terminology

Advanced

Behaviors

Required

Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well

Leader: Inspires teammates to follow them

Functional Expert: Considered a thought leader on a subject

Motivations

Required

Goal Completion: Inspired to perform well by the completion of tasks

Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization

If interested and qualified, e-mail douglas@alexanderbec.com and you will be contacted

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