Director of Billing

Overview

We are looking for a dynamic leader to join United Health Centers as our Director of Billing at our corporate office in Fresno, CA. This position is an exempt position that is fully in-person and Monday-Friday. 

This position is responsible for overseeing the employees and responsibilities of the Billing Department. The individual will design, implement, and enforce policies and procedures, as well as create efficient and effective billing processes across multiple payors. This position requires a strong leader with the ability to prioritize, plan, and direct the department's performance to meet the strategic goals of the United Health Centers of the San Joaquin Valley. The Billing Director is responsible for revenue maximization for all United Health Centers’ receivables. The Billing Director identifies, investigates, and resolves compliance issues relating to coding, billing, documentation, and reimbursement activities. Serves as a subject matter expert and authoritative resource on interpretation and application of documentation and coding rules and regulations. Researches, leads, and directs the implementation of compliance with new billing rules, regulations, laws, and payor contractual requirements. This position reports to the Chief Financial Officer (CFO).

Responsibilities

Summary of Responsibilities:

• Achieve Billing operational objectives in billing, collections, and staffing
• Ensure billing and collection record keeping and reporting systems are maintained
• Review claims and denials to ensure that 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.
• Fosters an environment that promotes teamwork and positive communications within the service area and department.
• Works to establish policies and procedures to assist UHC in maximizing contract provisions with health plans.
• Effectively communicates 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.
• Monitors effectiveness of collection efforts and maintains payment processing is current within the established time frame specified in the department policy.
• 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.

Establishment and Implementation of Managed Care Two-Plan Model for United Health Centers.

• Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable, follow-up, and reimbursement management.
• Serves as the practice expert and go to person for all coding and billing processes.
• Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings.
• 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.
• Keeps up to date with carrier rule changes and distribute the information within the practice.
• 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.