Director of Billing

About the role

This position is an exempt position that is fully in-person and Monday-Friday. The Billing Director oversees the employees and responsibilities of the Billing Department, designs, implements, and enforces policies and procedures, and creates efficient and effective billing processes across multiple payors. The role requires a strong leader with the ability to prioritize, plan, and direct the department's performance to meet the strategic goals of United Health Centers of the San Joaquin Valley.

Responsibilities

• Achieve Billing operational objectives in billing, collections, and staffing
• Review claims and denials to ensure they are prepared properly and follow-up when necessary
• Provide customer service and support to Medical Billing staff, patients and their families, medical and dental staff, clinical support staff, and all public and professional contacts associated with patient accounting and payment recovery
• Manage compliance of all federal, state, and private insurance carrier requirements
• Foster an environment that promotes teamwork and positive communications within the service area and department
• Work to establish policies and procedures to assist UHC in maximizing contract provisions with health plans
• Communicate changes regarding contracted health plans for claims processing, data management and information systems, financial management, eligibility verification, specialty panel access, patient tracking provider relations, patient satisfaction and health education to staff
• Maintain payment processing within the established time frame specified in the department policy
• Monitor effectiveness of collection efforts and ensures outstanding customer services are delivered consistently and within department and organization guidelines
• Works to foster an environment that promotes UHC's Quality Improvement Program
• Establish and implement a two-plan model for United Health Centers
• Oversee the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable, follow-up, and reimbursement management
• Serve as the practice expert and go-to person for all coding and billing processes
• Manage compliance of all federal, state, and private insurance carrier requirements
• Prepares and analyzes accounts receivable reports, weekly and monthly financial reports, and insurance contracts with the Chief Financial Officer
• Collects and compiles accurate statistical reports for general reporting or dashboard reporting
• Audits current procedures to monitor and improve efficiency of billing and collections operations
• Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and follow Federal, State, and payer regulations, guidelines, and requirements
• Participates in the development and implementation of operating policies and procedures
• Reviews and interprets operational data to assess need for procedural revisions and enhancements
• Participates in the design and implementation of specific systems, including practice management system to enhance revenue and operating efficiency
• Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures
• Understands and remains updated with current coding and billing regulations and compliance requirements
• Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations
• Maintains library of information/tools related to documentation guidelines and coding
• Works with the Billing Manager to direct billing office personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance
• Provides and oversees or coordinates the provision of training for new and existing billing staff on applicable operating policies, protocols, systems and procedures, standards, and techniques
• Performs other miscellaneous job-related duties as assigned
• Attends and actively participates in all meetings (e.g., department meetings, program meetings, employee staff meetings) and other activities as required or assigned

Qualifications

• Bachelor's Degree in Business or Health Administration or related field
• Minimum of five (5) years Medical Insurance/Healthcare Billing and Collections experience in a healthcare setting, preferably a FQHC, with a deep understanding of medical billing rules and regulations
• Two (2) years supervisory or management experience preferred

Skills

• Comfortable understanding of code sets (e.g., ICD-9, CPT, CDT, etc)
• Understanding and experience in contract negotiations
• Clear working knowledge of State and Federal regulations regarding managed care and Knox-Keene Health Plan Services Act
• Communication skills which include ability to draft corporate documents, procedural guides, technical writing, and agreement/MOU writing
• Bilingual (English/Spanish)
• Able to quickly build and maintain a rapport with patients and providers of differing backgrounds; team player
• Meeting facilitation and curriculum development skills that include understanding of adult learning and general training techniques
• Demonstrated effective problem-solving skills; sound judgement
• Effective leadership/supervisory skills
• Expert at modern office practices and procedures
• Intermediate to advanced computer skills including strong with MS Office (Word/Excel/PowerPoint/Access)
• Project management skills and experience
• Able to handle multiple tasks simultaneously

Prior Experience

• Minimum of five (5) years Medical Insurance/Healthcare Billing and Collections experience in a healthcare setting, preferably a FQHC, with a deep understanding of medical billing rules and regulations
• Two (2) years supervisory or management experience preferred

Salary Range

The salary range that UHC reasonably expect to pay for the position upon hire starts at $102,995.16. Our salaries are dependent on knowledge, skills, and experience. In addition, our comprehensive benefits package for regular status employees includes Medical, Dental, and Vision insurance with low premium cost, Paid time off and paid holidays, 401k plan with matching contribution, Educational Assistance, Employee discounts and more!