Billing Director

ABOUT THE ORGANIZATION:

• 9 paid holidays per year
• 3 weeks of PTO per year (on top of holidays). PTO increases to 4 weeks/year after 2 years of employment, and then to 5 weeks/year after 5 years of employment.
• Medical/Dental/Vision/Life Insurance
• 401k matching
• Tuition reimbursement
• Continuing education, reimbursement for professional certifications, and qualified supervision.

JOB SUMMARY:

The Billing Director will manage the billing process for behavioral health services to include Medicare, Medicaid and Commercial Insurance. The Billing Director is responsible for leading and directing the billing team in processing claims, resolving billing issues, and optimizing cash flow. The Billing Director is also responsible for maintaining and updating the billing software system and procedures.

ESSENTIAL JOB FUNCTIONS:

• Oversee the day-to-day operations of the billing department to include insurance verification, claim submissions, payment posting, and accounts receivable follow-up.
• Perform as the practice expert and go-to person in the department for all processes relating to billing and collections.
• Ensure accurate and timely billing complies with payer, State and Federal requirements, regulations and guidelines.
• Oversee provider credentialing that meets payer requirements.
• Maintain good working relationships with healthcare providers and insurance companies to resolve billing issues timely.
• Provide effective supervision including training, managing workload and problem resolution to the billing team.
• Ensure appropriate training is provided to business office managers in the programs and that established company operating policies, procedures and protocols are followed.
• Maintain and update the billing software system such as the Charge Master and billing forms. This includes changes in services to be billed, changes in reimbursement rates, setting up new providers and program locations, etc.
• Complete the Month-End close from the billing software system in a timely manner.
• Develop and implement billing policies and procedures. Review and update internal P&Ps annually including the Sliding Fee Schedule in compliance with federal poverty limits.
• In collaboration with senior management, review insurance contracts, analyze accounts receivable reports and billing performance and develop strategies to improve collections and reduce billing issues.
• Stay up to date with current billing and coding regulations and guidelines.
• Remain updated on HIPAA and all other health information management issues and regulations.

(These essential job functions are not to be construed as a complete statement of all duties performed. Employees will be required to perform other job related marginal duties as required.)

EDUCATION AND EXPERIENCE:

• Bachelor’s Degree in Business, Healthcare, and/or related field required.
• Minimum of 5 years of experience in medical insurance/healthcare billing practices in a healthcare system, preferably in behavioral health for substance abuse and mental health services.
• Minimum of 3 years working in a supervisory or management position.
• Working experience of medical terminology, appeal processes, and adherence to medical billing regulations including Medicare, Medicaid and Commercial Insurance.
• Proven track record for improving process efficiencies and solving problems.

(A comparable amount of training, education or experience may be substituted for the above minimum qualifications.)

KNOWLEDGE, SKILLS AND ABILITIES:

• Solid knowledge of basic accounting principles and business management
• Proficiency with billing software, electronic medical records and databases.
• Proficiency in the use of Word, Outlook, Excel and other Microsoft Office tools.
• Advanced customer service skills including clear and professional verbal and written communication skills and strong problem-solving abilities.
• Excellent organizational skills and attention to detail.
• Strong negotiation skills to effectively deal with payment and contract issues.

ESSENTIAL PHYSICAL SKILLS:

• Ability to write accurately and legibly

• Ability to sit at a desk and view a display screen for extended periods of time

• Ability to bend, stoop and reach

• Ability to sit in meetings for extended periods of time

• Ability to move throughout program facilities both indoors and outdoors

• Ability to lift and carry 10 pounds

• Good hearing and vision

SPECIAL REQUIREMENTS:

• Must pass a level II background check and drug screen.
• Must have a valid driver's license or state ID card.

Reasonable accommodations will be made for otherwise qualified individuals with a disability. Veterans encouraged to apply. Operation PAR Inc is a drug-free workplace that adheres to federal regulations as it pertains to marijuana use. EOE/ADA/VETERANS/DFWP