Katahdin Valley Health Center
Job Description
Billing Director
Reports To: Chief Executive Officer
Status: Salaried Exempt
Facility Location: All [In Person in either Brownville, ME - Dover-Foxcroft, ME or Patten, ME]
Hours: Varies
POSITION SUMMARY
The Billing Director will effectively lead the billing department with direct oversight of the Billing Managers, Billing Technicians, Claims Resolution Specialists, Referral Specialists, New Patient Coordinators and Billing Coders. The Billing Director is responsible for all third-party contract recommendations to the Chief Financial Officer and the Chief Executive Officer. The Billing Director is responsible for the strategic direction of the department. The Billing Director is responsible for the development, implementation, and administration of all policies and procedures relating to revenue cycle management.
RESPONSIBILITIES
1. Working knowledge in areas of patient access, billing, accounts receivable, cash management requirements, health insurance, and business office operations.
2. Ensures compliance with regulations and billing and collection policies in order to facilitate the attainment of accounts receivable (AR) targets.
3. Responsible for management of the Billing Departments, including timely annual performance appraisals, quality controls, training, hiring, and any staff discipline as needed.
4. Oversees accounts receivables and ensures KVHC collects maximum appropriate payments for all disciplines.
5. Assists in the development and maintenance of financial and accounting policies and procedures.
6. Assists in the development and review of department level training tools and plans for all roles in the Billing Department as well as support roles impacting revenue cycle management.
7. Manages and negotiates managed care contracts with the Chief Financial Officer and the Chief Executive Officer.
8. Leads revenue cycle improvements throughout the organization, including working with appropriate individuals in the front office, medical records, billing, etc., to aid in the resolution of identified revenue cycle issues.
9. Performs ongoing trend analysis on third-party payer payment levels to ensure that reimbursement is in accordance with allowable amounts stated in agreements and contracts. Works with appropriate individuals to resolve discrepancies.
10. Develop monthly financial analysis to monitor revenue cycle management.
11. Performs month-end accounting functions as directed by the Chief Executive Officer.
12. Supports the development of current infrastructure and special projects, e.g., capital budget, department P and L’s, departmental budgeting.
13. Assist with the management of administrative functions, including risk management and employee compensation, benefits, and relations; contract negotiation, administration, and compliance in conjunction with Chief Executive Officer, Chief Operations Officer, and Human Resources Director.
14. Implement segregation of duties for all supervised departments.
15. Involved in financial strategic planning.
16. Stays current on all Medicare, Medicaid, and other grant and government reimbursement regulations and communicates information.
17. Represents KVHC as requested.
18. Actively participates as a member of the Risk Management and Compliance Committee.
19. Participates in senior management oversight of KVHC.
20. Assumes other financial management, leadership, and administrative responsibilities as requested.
21. Performs additional duties or projects as assigned by the Finance Officer.
22. Adheres to all KVHC policies and protocols.
23. Complies with all safety rules and protocols. Reports all incidents, regardless of severity, immediately to their supervisor and completes an incident report and investigation form, which will be forwarded to Human Resources within 24 hours of the incident.
24. Conducts themselves as a good steward in the communities served by KVHC; represents the organization at outreach activities as needed.
25. Actively participates as committee member as assigned by the Chief Executive Officer.
26. Interacts harmoniously and effectively with others. Focusing on the attainment of organization goals and objectives through a commitment to team work.
27. Conforms to acceptable attendance and punctuality standards as expressed in the employee handbook.
28. Abides by the organization’s compliance program and requirements
29. At times you may be faced with challenges that may impact patient care. Addressing these challenges may not be in your job description, however Katahdin Valley Health Center encourages each team member to go above and beyond to address the patients’ needs in the moment. Employees have the autonomy to see the care experience through from A to Z to show our patients KVHC C.A.R.E.S.
30. The employee may be responsible for traveling to multiple locations as specified in their job offer and/or contract.
31. As part of KVHC's commitment to a safe, respectful, and compliant workplace, KVHC utilizes security monitoring systems. Surveillance is conducted in accordance with all applicable laws, regulations and company policies/protocols to protect our employees, patients, and assets.
32. This position requires compliance with all applicable Federal, State, and local laws and regulations, KVHC’s Corporate Compliance Program, and KVHC’s policies and procedures (including the Standards of Conduct). Such compliance shall be an element considered as part of the positions regular performance evaluation. Failure to comply or failure to report actual or potential noncompliant conduct, may result in compliance consequences, up to and including termination and reporting to appropriate governmental authorities, regulatory bodies, law enforcement, licensing bodies, or other outside entities (“appropriate entities”).
PROFESSIONAL EXPECTATIONS
1. Admit mistakes or missteps openly, own your own behavior, forgive one another, and model vulnerability and humility.
2. Keep discussions about team members, subordinates, and colleagues as well as challenges in the workplace, positive, constructive, and factual.
3. Be mindful of employee confidentiality even among peers, and particularly where an issue involves a peer.
4. Only say what you would be willing to say to someone directly.
5. Whenever possible, speak directly to the person with whom you are having a disagreement or a challenge. Challenge yourself to engage in these discussions. Do not avoid constructive conflict.
6. Work with your supervisor or HR when you need to process a performance or behavioral situation with a colleague or subordinate to determine next steps.
7. It is always okay, and usually preferable, to pause, and take time to reflect before reacting to a situation.
EDUCATION AND EXPERIENCE
1. CPA or MBA preferred. With five or more years of experience in a high level non-profit financial management position.
2. Knowledge of the principles of financial management and accounting sufficient to direct staff and coordinate all aspects involved with fiscal requirements.
3. Knowledge of the health care financial and budgetary practices to develop an annual budget, analyze financial data and patterns, manage AR, and prepare statements.
4. Knowledge of governmental and healthcare fiscal regulations and reporting requirements.
5. Skill in exercising a high degree of leadership, initiative, judgment, discretion, conflict resolution, and decision-making skills to achieve KVHC objectives.
6. Strong Supervisory/Management Background.
7. Experience with completing complex project management tasks with little supervision.
8. Skill in identifying and resolving problems.
9. Ability to communicate clearly and to maintain strict confidentiality.
10. Carries out responsibility for related corporations or organizations under contract with KVHC.
11. Excellent word processing, Excel, database, and other computer skills. Excellent writing skills.
12. High School Diploma or GED, or a combination of education and experience.
13. Certification as a Professional Coder.
14. Completion of Anatomy & Physiology, and Medical Terminology Courses.
15. Experience in Medical Billing and Coding.
16. Strong Computer Skills.
17. Ability and education to perform coding and CPT Utilization Audits.
18. Ability to work well with co-workers, clients and providers.
19. Flexible schedule in order to attend evening provider meetings.
20. Data Entry experience.
21. Strong written and verbal communication skills.
22. Must possess a clean criminal and DHHS background.
23. Must possess the ability and means to travel between clinics as needed.
24. Valid State of Maine Driver’s license and ability to be insured by KVHC’s vehicle insurance carrier.
FUNCTION, DEMANDS AND PHYSICAL PERFORMANCE
Requires full range of body motion with the ability to bend, kneel and stoop. Must possess: the ability to sit and or stand for long periods of time, the ability to lift approximately 30 lbs., visual acuity with color vision, the ability to communicate effectively and calmly in a professional manner, the ability to follow all workplace policies including safety and confidentiality, the ability to perform repetitive motion keyboarding functions, exposure to communicable disease, toxic substances, medicinal preparations and other conditions common to clinic environment. Knowledge of organizational policies, regulations, and procedures to administer patient care. Must possess the ability to work with and around medical equipment and instruments safely and effectively as appropriate. Knowledge of common safety hazards and precautions to establish a safe work environment including Safety Data Sheets. Skill in preparing and maintaining records, writing reports, and responding to correspondence. Skill in developing and maintaining department quality assurance. Skill in establishing and maintaining effective working relationships with patients, medical staff, and the public. Ability to maintain quality control standards. Ability to react calmly and effectively in emergencies. Ability to interpret, adapt and apply guidelines and procedures. Ability to communicate clearly.
CONFIDENTIALITY OF PATIENT INFORMATION AND ALL KVHC HEALTH CENTER BUSINESS IS ESSENTIAL. EMPLOYEES MUST COMPLY WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996-PUBLIC LAW 104-191
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Retirement plan
- Tuition reimbursement
- Vision insurance
Work Location: In person
