The Assistant Director position is a full-time position responsible for the medical billing, coding and collection of the primary care clinic activities and behavioral health billing activities. Also the Assistant Director will support the Director or Receivables Management in the billing and collection of the grants, contracts, and oversee the operations of the department. This position ensures compliant billing practices, resolves complex billing issues, and ensures maximum reimbursement while maintaining excellent patient and provider relations. The Assistant Director serves as the subject matter expert for billing and coding processes and ensures compliance with all federal, state, payer, and organizational regulations.
General Expectations:
In the performance of their respective tasks and duties, all employees are expected to conform to the following:
Adhere to all PRC policies and Code of Conduct standards and always exhibit all PRC’s Core Values.
Perform quality work within deadlines with or without direct supervision.
Interact professionally with other employees, customers, and vendors.
Work independently, while understanding the necessity for communicating and coordinating work efforts with other employees and organizations, as required.
Essential Duties/Requirements:
Assist in overseeing the daily operations of the billing department, including medical and behavioral health coding, charge entry, claims submission, payment posting, accounts receivable following denial management and reimbursement
Responsible for the coding, billing, and collection of the primary care clinic activities and behavioral health services
Work collaboratively with the physician and clinic staff to develop new service offerings to our clients
Serve as the primary care clinic’s subject matter expert for billing and coding processes and provide guidance to staff and providers as needed
Ensure accurate and timely submission of claims to primary, secondary, and tertiary payers
Monitor denied, unpaid, and rejected claims and coordinated appeals, corrections, and resubmissions
Review and reconcile billing reports, payment postings, and accounts receivable balances
Generate patient statements and invoices, including prior payments and outstanding balances
Ensure payments are accurately posted to the appropriate patient accounts and line items
Maintain current knowledge of payer requirements, coding updates, regulatory changes and communicate updates to staff on primary care and behavioral health services
Monitor compliance with federal, state, payer, and organizational billing and coding regulations
Maintain documentation resources and coding reference tools related to billing compliance and documentation standards
Assist in developing and implementing billing policies, procedures, and workflow improvements to maximize revenue cycle efficiency
Prepare and present detailed billing, collections, productivity, and reimbursement reports to leadership
Collaborate with providers, clinical staff, Billing department staff, and management to resolve billing discrepancies and improve revenue cycle operations
Ensure protection and confidentiality of patient information in compliance with HIPAA regulations
Assist with audits and respond to billing inquiries from patients, insurance carriers, and regulatory agencies
Provide support to the Director of Receivables Management in order to fill in as needed
Support departmental goals and participate in process improvement initiatives
Qualifications:
Education:
Associate degree required; Bachelor’s degree in Business, Healthcare Administration, or related field preferred
Experience:
Minimum of three (3) years of medical billing, coding, insurance, and collections experience within a medical practice; medical clinic billing experience required. Prior supervisory or management experience preferred.
Certifications:
Medical coding certification preferred (CPC, CCS, or equivalent)
Knowledge and Skills:
Strong understanding of medical billing regulations, insurance requirements, and reimbursement methodologies
Proficiency with Electronic Medical Records (EMR) systems and claims billing software
Familiarity with CPT, ICD-10, and HCPCS coding and medical terminology
Knowledge of HIPAA regulations and patient confidentiality requirements
Strong analytical, mathematical, and problem-solving skills
Excellent communication and people skills
Ability to multitask, prioritize responsibilities, and meet deadlines in a fast-paced environment
Ability to work independently and collaboratively within a team environment
Strong organizational and leadership abilities
Physical Requirements:
Prolonged periods of sitting and working on a computer
Ability to communicate effectively in person, by phone, and electronically
Ability to occasionally lift up to 15 pounds
Safety Equipment
Universal Precautions
Comply with Occupational Safety and Health Administration (OSHA) rules and regulations
Life Safety Equipment (fire extinguisher)
Transportation:
Must have dependable transportation
Machines, Tool, and Equipment Used:
Computer, telephone, fax, copier
Technology Requirement:
As an employee of Peace River Center, if you are not assigned a company-issued phone, you will be required to authorize the use of the Microsoft Authenticator app on your personal mobile device. This is necessary to access our payroll and communication system, Datis, and Microsoft email, as examples. This will ensure secure and efficient communication with the organization.
Supervisory Relationship(s)
Assist with and is responsible for the billing staff and operations in the absence of the Director.
Work Environment:
The work environment is fast-paced and consists of exposure to physical conditions typical of a normal office environment. The populations cared for will include patients who are confused, delusional, irrational, agitated, or uncooperative. Most of the work is performed while sitting, although the work may require occasional standing or walking and/or the lifting and carrying of small objects. A small amount of travel may be required for meetings, etc., to another PRC location.
EEO Statement
One of the greatest assets of the PRC is the ethnic, cultural, and social diversity of its employees. PRC takes great pride in the diversity and values and respect of all its employees, regardless of race, color, sex, marital status, religion, national origin, ancestry, genetic information, age, disability, gender identification, or sexual orientation.
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