Job Title:
Director of Billing
General Job Summary: This position is responsible for supervising billing staff and all billing activities.
Reports To: Administrator and Physician Partners
Supervises: Billing Department Staff
Primary Duties and Responsibilities:
1. Supervise billing staff - Communicate regarding expectations, productivity, and any issues or concerns. Prepare evaluations, and approve time-off
2. Monitor AIR Balance Daily - Identify trends and variances
3. Accounts Research - charges, payments, and adjustments
4. Monitor Rejected claims daily, make cotTections, re-file
5. Monitor Filed Claims and resubmit, as needed
6. Unpaid Claims
7. Patient Accounts
8. Collection Accounts
9. Credit Balances (Overpayments & Refunds)/Research and Accuracy
10. Patient Concerns-Speak with irate/upset patients regarding their concerns, and solve problems as soon as possible
11. Identify workflow problems and make necessary changes in order to enhance productivity and accuracy
12. Identify reimbursement problems and make necessary corrections
A. Work with clinical staff regarding pre-certs, and pre-auths, when deficiencies are identified. Implement quality assurance measures so that BB&J receives full reimbursement for each and every procedure performed
B. Communicate with Front Office staff regarding deficiencies which impact reimbursement i.e. referrals, insurance information, etc.
C. Monitor office collections ( deductibles/copays), because this decreases accounts receivable, increases cash flow, and ultimately reduces overhead
D. Implement policies/procedures in order to maximize reimbursement
E. DME - Work with BB&J team to maximize reimbursement
13. Review EOBs for reimbursement accuracy, payment posting accuracy, and adjustment accuracy
14. Research Insurance carrier updates, and communicate updates to physicians and staff Implement changes when necessary in order to maintain compliance
15. Maintain relationships with insurance carrier provider representatives -
(The provider representatives are very helpful when we have a reimbursement problem)
16. Provide special Financial/Coding/Marketing reports, as requested by office administrator and physicians - It should be noted that the "canned" reports provided with the practice management software (Centricity) does not produce all of the reports that are needed for analysis. In many cases several reports are generated from Centricity and the data has to be manipulated in order to produce the desired report.
17. Troubleshoot simple computer problems (billing office, and other areas when Kathy is unavailable), which in most cases prevents a call to IT support
18. Review insurance carrier credentialing requests, research, and make recommendations to office administrator
19. Work with Athena, Phreesia, and WhitePlume, and SRS regarding updates and problems. Obtain quotes for license agreements, Clearinghouses. Supply information to Athena for Electronic claims processing, remit processing, and eligibility enrollment
20. Work with supply vendors regarding products and coding updates
21. Maintain Centricity billing database: Allowed amounts, Update Fee Schedules, Add insurance carriers, procedure codes, Fees, and physicians.(These duties are currently being completed by me only. This is because the database was not being maintained appropriately, when I moved into the billing department. Too many people were making changes/additions without the proper training or knowledge.)
22. Communication and quality assurance with billing contractor (The Coding Network)
23. Monthly Tasks:
A. Identify any posting errors before closing the billing month in Centricity
B. "Hard Close" current billing month in Centricity
C. Prepare monthly billing reports for Practice Administrator, Physicians and Accountant
D. Research and Analyze monthly reports and prepare summary
E. Review Adjustment, and Aging reports. Assign staff aged claims for follow-up
24. Quarterly Tasks:
A. Prepare quarterly billing reports for Practice Administrator, Physicians and Accountant - Identify and research trends and variances
B. Prepare Marketing spreadsheets and graphs for Pam Denham and Associates. These spreadsheets and graphs are presented to the physicians in Pam's memo and quarterly report. (I have been creating these spreadsheets and graphs, since the 2nd Quarter of 2009)
C. Quarterly Infodive Upload
25. Annually Tasks:
A. Download new ICD-9/CPT codes in Centricity
B. Order Coding Manuals for Office
C. Prepare for Medicare (and other Carrier) changes
D. Attend training regarding coding changes/updates for the new year
26. Projects as assigned by Administrator or Physicians
Education: High school diploma or equivalent. Some college preferred & CPC certification preferred.
Experience: Minimum 5 years of billing/coding experience preferred, including one year with a health care organization (preferred). Orthopedic experience preferred.
Licensure Requirements: None.
Knowledge:
1. Knowledge of medical billing practices, policies, and systems.
2. Knowledge of organizational policies, procedures, and systems.
3. Knowledge of office management techniques and practices.
4. Knowledge of research methods and procedures sufficient to compile data and prepare reports.
5. Knowledge of grammar, spelling, and punctuation.
6. Knowledge of purchasing, budgeting, and inventory control.
Skills:
1. Skill in taking and transcribing dictation and operating office equipment.
2. Skill in answering the phone and responding to questions.
3. Skill in time management, prioritization, and multitasking.
4. Skill in problem-solving.
5. Skill in writing and communicating effectively.
Abilities:
1. Ability to establish and maintain effective working relationships with other employees and the public.
2. Ability to work under pressure, communicate and present information.
3. Ability to read, interpret, and apply clinic policies and procedures.
4. Ability to identify problems, recommend solutions, organize and analyze information.
5. Ability to multi-task, establish priorities, and coordinate work activities.
6. Ability to work as part of a team.
7. Ability to competently use Microsoft Office, including Word, PowerPoint, Excel, and appropriate practice management software.
Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.
Work Environment: Position is in a well-lighted medical office environment. Occasional evening and weekend work.
Mental/Physical Requirements: Must possess the physical and mental abilities to perform the tasks normally associated with an Administrative Assistants such as sitting for 90 percent of the day; manual dexterity to operate office machines including computer and calculator; stooping, bending to handle files and supplies; and mobility to complete errands or deliveries. Stress can be common due to multiple staff demands and deadlines.
As an employee of a Covered Entity, this position requires full compliance with HIPAA & HITECH rules. Positions with Baldwin Bone and Joint, PC also require employees to comply with internal policies and procedures designed to allow full compliance by the individual and the Company. These policies, procedures and protocols include physical, technical and administrative safeguards to protect and control access to PHI in accordance with Federal regulations. Under current laws, individuals and the Company are subject to specified sanctions, varied penalties and certain levels of fines for non-compliance, each dependent upon the investigated circumstances.
Job Type: Full-time
Pay: From $60,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible schedule
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: In person
